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General NPI Number Information
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NPI Number | 1528224953
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Entity Type | Individual
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Provider Name | DEBORAH A. CONWAY P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 10201 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1917
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Country | US
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Telephone | 773-779-7273
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Fax |
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Provider Business Mailing Address
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Address Line | 10344 S HAMILTON AVE
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City | CHICAGO
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State | IL
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Zip | 60643-2415
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Country | US
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Telephone | 773-779-6064
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Fax |
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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 | 070001399
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License Number State | IL
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