Healthcare Provider Details

I. General information

NPI: 1801655642
Provider Name (Legal Business Name): DONOVAN CAUFIELD PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S MADISON ST
IOWA CITY IA
52240-3841
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 319-248-0373
  • Fax: 319-569-8238
Mailing address:
  • Phone: 630-575-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number115373
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: