Healthcare Provider Details

I. General information

NPI: 1891851341
Provider Name (Legal Business Name): DEBRA M CERONE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 DANADA SQ E
WHEATON IL
60187-8484
US

IV. Provider business mailing address

600 OAKMONT LN STE 600C
WESTMONT IL
60559-5548
US

V. Phone/Fax

Practice location:
  • Phone: 630-588-8840
  • Fax: 630-588-8842
Mailing address:
  • Phone: 630-575-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number07003887
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: