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General NPI Number Information
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NPI Number | 1215229109
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Entity Type | Individual
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Provider Name | CHAD D DOERNEMAN PT
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Gender | Male
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 06/25/2016
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Provider Practice Location Address
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Address Line | 119 N 51ST ST SUITE 101
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City | OMAHA
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State | NE
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Zip | 68132-2867
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Country | US
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Telephone | 102-506-5695
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Fax | 402-596-6758
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone | 630-296-2223
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Fax | 630-759-9510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3010
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License Number State | NE
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