Healthcare Provider Details

I. General information

NPI: 1801563390
Provider Name (Legal Business Name): JOSEPH UZELAC PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N UNION ST STE 101NA
WILMINGTON DE
19805-3453
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 302-778-0810
  • Fax: 302-778-0812
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0014682
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: