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NPI Code Detail

MEDICARE: SADIE TENHAGEN DPT

MEDICARE: SADIE TENHAGEN 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 Therapist16366-24WI

General Provider Information

NPI Number : 1336823459
Entity Type Code : Individual
Provider Name (Legal Business Name) : SADIE TENHAGEN 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 : 630-575-1980
Fax Number : 630-928-5080
Provider Business Practice Location Address
First Line : 315 N MILWAUKEE ST
Second Line :
City : WATERFORD
State : WI
Zip : 53185-4432
Country : US
Telephone Number : 262-558-8599
Fax Number : 262-758-5468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2023
Last Update Date : 06/09/2023

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Directions to “ SADIE TENHAGEN DPT” Practice Location

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