Healthcare Provider Details

I. General information

NPI: 1932369402
Provider Name (Legal Business Name): DAVID PLEVA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2171 W EXECUTIVE DR SUITE 450
ADDISON IL
60101-5625
US

IV. Provider business mailing address

2171 W EXECUTIVE DR SUITE 450
ADDISON IL
60101-5625
US

V. Phone/Fax

Practice location:
  • Phone: 630-282-5588
  • Fax: 630-282-5587
Mailing address:
  • Phone: 630-282-5588
  • Fax: 630-282-5587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number070007098
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: