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General NPI Number Information
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NPI Number | 1790352458
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Entity Type | Individual
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Provider Name | JAMES ROBERT ZEBOLD PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 111 N LARKIN AVE STE C
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City | JOLIET
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State | IL
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Zip | 60435-7833
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Country | US
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Telephone | 779-970-5100
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Fax | 779-221-8087
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Provider Business Mailing Address
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Address Line | PO BOX 416501
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City | BOSTON
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State | MA
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Zip | 02241-7594
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Country | US
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Telephone | 914-294-4050
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Fax | 631-760-8306
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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 | 070025951
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License Number State | IL
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