Healthcare Provider Details

I. General information

NPI: 1356869531
Provider Name (Legal Business Name): AMANDA BARTZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7191 S KINGERY HWY STE L6
WILLOWBROOK IL
60527-5525
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 630-455-6630
  • Fax: 630-455-6631
Mailing address:
  • Phone: 630-296-2222
  • Fax: 630-759-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070023066
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: