MEDICARE: JUSTIN ENGLE PT, 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
1	225100000X	Physical Therapist	1304306	TX

General Provider Information

NPI Number	:	1417447608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN ENGLE PT, 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	:	630-575-7198
Fax Number	:	410-648-4878

Provider Business Practice Location Address
First Line	:	4560 HERITAGE TRACE PKWY STE 200
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-8953
Country	:	US
Telephone Number	:	817-697-5742
Fax Number	:	817-204-1043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	09/30/2025

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Directions to “ JUSTIN ENGLE PT, DPT” Practice Location

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