Healthcare Provider Details

I. General information

NPI: 1023013273
Provider Name (Legal Business Name): AMY HANNA PARIBELLO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 WEBSTER ST
MONTGOMERY IL
60538-1324
US

IV. Provider business mailing address

3015 E NEW YORK ST. STE A2 #274
AURORA IL
60504-5162
US

V. Phone/Fax

Practice location:
  • Phone: 630-326-7654
  • Fax: 630-597-2545
Mailing address:
  • Phone: 513-535-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070012326
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: