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NPI Code Detail

MEDICARE: NICHOLAS CHARON DPT

MEDICARE:   NICHOLAS  CHARON  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 TherapistPT020856OH

General Provider Information

NPI Number : 1871352898
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS CHARON 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 :
Provider Business Practice Location Address
First Line : 7480 BROADVIEW RD
Second Line :
City : PARMA
State : OH
Zip : 44134-5718
Country : US
Telephone Number : 440-481-1290
Fax Number : 440-340-7184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2024
Last Update Date : 06/12/2024

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Directions to “ NICHOLAS CHARON DPT” Practice Location

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