Healthcare Provider Details

I. General information

NPI: 1902737661
Provider Name (Legal Business Name): MICHELLE BRENNAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 CHURCH RD STE 101
AURORA IL
60502-8943
US

IV. Provider business mailing address

2635 CHURCH RD STE 101
AURORA IL
60502-8943
US

V. Phone/Fax

Practice location:
  • Phone: 630-315-8700
  • Fax: 630-315-6979
Mailing address:
  • Phone: 630-315-8700
  • Fax: 630-315-6979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.039885
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: