Healthcare Provider Details

I. General information

NPI: 1184757510
Provider Name (Legal Business Name): DIXON PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 N GALENA AVE STE 400
DIXON IL
61021-1568
US

IV. Provider business mailing address

841 N GALENA AVE STE 400
DIXON IL
61021-1568
US

V. Phone/Fax

Practice location:
  • Phone: 815-285-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL JAMES TUNINK
Title or Position: DIRECTOR
Credential: DPT, PT, OCS
Phone: 815-988-3653