Healthcare Provider Details

I. General information

NPI: 1689243412
Provider Name (Legal Business Name): DANIELLE ROSE DOPPELT LEVIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 N SHEFFIELD AVE STE 411
CHICAGO IL
60657-5084
US

IV. Provider business mailing address

533 S DIVISION ST STE B
ELMHURST IL
60126-3982
US

V. Phone/Fax

Practice location:
  • Phone: 331-215-4164
  • Fax:
Mailing address:
  • Phone: 331-215-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.025883
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: