Healthcare Provider Details

I. General information

NPI: 1780415331
Provider Name (Legal Business Name): DANA PODELL PHYSICAL THERAPY & YOGA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 DEMPSTER ST
EVANSTON IL
60202-1003
US

IV. Provider business mailing address

1818 DEMPSTER ST
EVANSTON IL
60202-1003
US

V. Phone/Fax

Practice location:
  • Phone: 773-800-4330
  • Fax:
Mailing address:
  • Phone: 773-800-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANA PODELL
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, E-RYT
Phone: 773-800-4330