=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255297180
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA GLEDHILL DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16910 SOUTHFIELD RD
-----------------------------------------------------
City | ALLEN PARK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48101-2574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-637-9601
-----------------------------------------------------
Fax | 313-725-9305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2122 YORK RD STE 300
-----------------------------------------------------
City | OAK BROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60523-1925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-575-6200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5501304264
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------