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General NPI Number Information
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NPI Number | 1558235895
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Entity Type | Individual
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Provider Name | JOSEPH BRUCE SAMPSON PT, DPT, CLT
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Gender | Male
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1801 W TAYLOR ST STE 2C
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City | CHICAGO
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State | IL
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Zip | 60612-4795
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Country | US
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Telephone | 312-355-4394
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Fax |
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Provider Business Mailing Address
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Address Line | 220 W ILLINOIS ST UNIT 1305
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City | CHICAGO
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State | IL
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Zip | 60654-4631
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Country | US
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Telephone | 540-661-7151
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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 | 070.028313
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License Number State | IL
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