Noah Alexander Tadevich, DPT
Physical Therapist in Burr Ridge, IL. Individual provider (NPI-1).
NPI number1619640232
StatusActive
Last updated in NPPESJun 14, 2022
Details
- NPI
- 1619640232
- Entity type
- Individual (NPI-1)
- Name
- Noah Alexander Tadevich
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 29, 2021
- Certification date
- Jun 14, 2022
- Last updated
- Jun 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 070024761 | IL | Yes |
Practice location
860 Village Center DrBurr Ridge, IL 60527-4519
Phone 630-469-9200
Mailing address
1860 Paysphere CirChicago, IL 60674-0018
Phone 630-469-9200
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