Healthcare Provider Details
I. General information
NPI: 1013838598
Provider Name (Legal Business Name): MATTHEW THOMAS CRANE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6300 KINGERY HWY STE 204
WILLOWBROOK IL
60527-2326
US
IV. Provider business mailing address
13253 W WOODLAND DR
HOMER GLEN IL
60491-8760
US
V. Phone/Fax
- Phone: 630-891-3980
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251S0007X |
| Taxonomy | Sports Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: