Basic Information
Provider Information
NPI: 1457361479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALENTINI
FirstName: JEFF
MiddleName: D
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 E STATE PKWY
Address2: SUITE E
City: SCHAUMBURG
State: IL
PostalCode: 601734569
CountryCode: US
TelephoneNumber: 6302858007
FaxNumber: 6302858017
Practice Location
Address1: 360 W BUTTERFIELD RD
Address2: SUITE 315
City: ELMHURST
State: IL
PostalCode: 601265068
CountryCode: US
TelephoneNumber: 6308339446
FaxNumber: 6308339680
Other Information
ProviderEnumerationDate: 08/09/2006
LastUpdateDate: 12/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X070-012971ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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