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NPI Code Detail

MEDICARE: JON ALEX CANTAL DPT

MEDICARE: JON ALEX CANTAL 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 Therapist4192NV

General Provider Information

NPI Number : 1437783263
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON ALEX CANTAL DPT
Provider Business Mailing Address
First Line : 2001 BUTTERFIELD RD STE 1600
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-1211
Country : US
Telephone Number : 866-370-8206
Fax Number : 517-435-3670
Provider Business Practice Location Address
First Line : 4370 BLUE DIAMOND RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-7787
Country : US
Telephone Number : 702-443-9301
Fax Number : 702-342-0600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2020
Last Update Date : 01/30/2025

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