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NPI Code Detail

MEDICARE: RICHARD DAIGNAULT III DPT

MEDICARE: RICHARD DAIGNAULT III 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 Therapist070019610IL

General Provider Information

NPI Number : 1881938264
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD DAIGNAULT III DPT
Provider Business Mailing Address
First Line : POB 7132960
Second Line :
City : CHICAGO
State : IL
Zip : 60677-0001
Country : US
Telephone Number : 630-469-9200
Fax Number :
Provider Business Practice Location Address
First Line : 536 S YORK ST
Second Line :
City : ELMHURST
State : IL
Zip : 60126-3952
Country : US
Telephone Number : 630-967-2000
Fax Number : 630-967-2350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2012
Last Update Date : 05/30/2025

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