Healthcare Provider Details

I. General information

NPI: 1124566781
Provider Name (Legal Business Name): EMILY ZIPOY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41W655 SILVANA DR
ELGIN IL
60124-8370
US

IV. Provider business mailing address

41W655 SILVANA DR
ELGIN IL
60124-8370
US

V. Phone/Fax

Practice location:
  • Phone: 847-533-7713
  • Fax:
Mailing address:
  • Phone: 847-533-7713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number12310
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: