Healthcare Provider Details

I. General information

NPI: 1376805861
Provider Name (Legal Business Name): MICHAEL ANTHONY SABOL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37464 LION DR UNIT 4
SELBYVILLE DE
19975
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 302-988-1586
  • Fax: 302-988-1593
Mailing address:
  • Phone: 803-812-3656
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003035
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: