Healthcare Provider Details

I. General information

NPI: 1831038041
Provider Name (Legal Business Name): ANDREW HUEBLER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 W CENTENNIAL PL # D318
ADDISON IL
60101-1075
US

IV. Provider business mailing address

1573 W IRVING PARK RD APT 318D
ITASCA IL
60143-3307
US

V. Phone/Fax

Practice location:
  • Phone: 630-953-0343
  • Fax:
Mailing address:
  • Phone: 630-953-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160.010006
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: