MEDICARE: ALEX DUNN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	225100000X	Physical Therapist	05013458A	IN

General Provider Information

NPI Number	:	1821652983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX DUNN

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8235 E 116TH ST STE 220
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-1554
Country	:	US
Telephone Number	:	317-813-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2019
Last Update Date	:	12/03/2024

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1316593841 — STEFANIE L BRACKEN PT, DPT
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Directions to “ ALEX DUNN ” Practice Location

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