Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 070.019882 | IL |
Y | 2251P0200X | Physical Therapist - Pediatrics | 070.019882 | IL |
N | 2251X0800X | Physical Therapist - Orthopedic | 070.019882 | IL |
NPI | 1598175937 |
---|---|
Provider Name | Mary Therese Lhotak |
First Address | Hanover Park, IL 60133-2910 |
Second Address | Naperville, IL 60564-9360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 03/09/2019 |