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NPI 1750262457

NPI 1750262457 : HENNA ANGEL DI DPT, PT : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1750262457
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    Entity Type          |    Individual 
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    Provider Name        |    HENNA ANGEL DI DPT, PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/09/2025
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    Last Update Date     |    09/09/2025
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Provider Practice Location Address
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    Address Line         |    1969 W OGDEN AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60612-3765
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    Country              |    US
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    Telephone            |    312-864-6000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1806 N SHEFFIELD AVE UNIT 2 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60614-0565
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    Country              |    US
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    Telephone            |    
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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       |    070.029104
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    License Number State |    IL
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