Healthcare Provider Details

I. General information

NPI: 1538325162
Provider Name (Legal Business Name): NATALIE MCINTIRE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE UNGER DPT

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 N CLYBOURN AVE UNIT S
CHICAGO IL
60614
US

IV. Provider business mailing address

600 OAKMONT LN STE 600C
WESTMONT IL
60559-5548
US

V. Phone/Fax

Practice location:
  • Phone: 773-871-3100
  • Fax: 773-871-7338
Mailing address:
  • Phone: 630-575-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070-015241
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: