Healthcare Provider Details

I. General information

NPI: 1679491195
Provider Name (Legal Business Name): OWEN EPPEL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7055 GRAND AVE
GURNEE IL
60031-1603
US

IV. Provider business mailing address

982 E SHORE DR
FOX LAKE IL
60020-1000
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.039866
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: