MEDICARE: DYLAN WELCH PT, DPT, OCS

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	299184	CA
2	2251S0007X	Sports Physical Therapist	299184	CA

General Provider Information

NPI Number	:	1932086154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DYLAN WELCH PT, DPT, OCS

Provider Business Mailing Address
First Line	:	1829 N DRAKE AVE APT 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6134
Country	:	US
Telephone Number	:	215-740-8637
Fax Number	:

Provider Business Practice Location Address
First Line	:	1026 OGDEN AVE STE 1026
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-2812
Country	:	US
Telephone Number	:	630-856-7600
Fax Number	:

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

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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