MEDICARE: ANIL JOSEPH 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	070-022857	IL
2	225100000X	Physical Therapist	31842	FL

General Provider Information

NPI Number	:	1437606381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL JOSEPH DPT

Provider Business Mailing Address
First Line	:	625 ENTERPRISE DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8813
Country	:	US
Telephone Number	:	630-575-6250
Fax Number	:	630-575-7450

Provider Business Practice Location Address
First Line	:	4639 W DIVERSEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-1828
Country	:	US
Telephone Number	:	773-360-5485
Fax Number	:	773-360-5486

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

Provider Enumeration Date	:	09/08/2016
Last Update Date	:	03/02/2017

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Directions to “ ANIL JOSEPH DPT” Practice Location

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