Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | IL | |
N | 2251E1200X | Ergonomics | IL | |
N | 225XE1200X | Ergonomics | IL | |
N | 2251N0400X | Physical Therapist - Neurology | IL | |
N | 2251S0007X | Physical Therapist - Sports | IL | |
N | 2251X0800X | Physical Therapist - Orthopedic | IL |
NPI | 1720057250 |
---|---|
Provider Name | Ms. Martha Ferry Biondi |
First Address | Highland Park, IL 60035-2538 |
Second Address | Highland Park, IL 60035-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004932465 | BLUE CROSS BLUE SHIELD (01) | IL |