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NPI Code Detail

MEDICARE: SUSAN BYDLON P.T.

MEDICARE:   SUSAN  BYDLON  P.T.
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 Therapist05002188AIN

General Provider Information

NPI Number : 1275596819
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN BYDLON P.T.
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2222
Fax Number :
Provider Business Practice Location Address
First Line : 2333 POST DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-1979
Country : US
Telephone Number : 317-890-7700
Fax Number : 317-890-4400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 02/15/2016

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Directions to “ SUSAN BYDLON P.T.” Practice Location

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