MEDICARE: DANIELLE M MCINTYRE 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	082896	IA

General Provider Information

NPI Number	:	1467905109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE M MCINTYRE DPT

Provider Business Mailing Address
First Line	:	600 OAKMONT LN STE 600C
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-5548
Country	:	US
Telephone Number	:	630-590-4029
Fax Number	:	630-590-4329

Provider Business Practice Location Address
First Line	:	779 MORMON TREK BLVD
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52246-1812
Country	:	US
Telephone Number	:	319-248-2020
Fax Number	:

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

Provider Enumeration Date	:	07/29/2016
Last Update Date	:	02/18/2019

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