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NPI Code Detail

MEDICARE: NICHOLAS YENCER DPT

MEDICARE: NICHOLAS YENCER DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist138646IA
2225100000XPhysical Therapist070027235IL

General Provider Information

NPI Number : 1275232068
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS YENCER DPT
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-6200
Fax Number :
Provider Business Practice Location Address
First Line : 2350 N LINCOLN AVE STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60614-3442
Country : US
Telephone Number : 773-281-7991
Fax Number : 773-281-2590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2023
Last Update Date : 06/25/2026

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Directions to “ NICHOLAS YENCER DPT” Practice Location

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