Basic Information
| Provider Information | |||||||||
| NPI: | 1679772990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | L'ABBE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 511 E HAWLEY ST | ||||||||
| Address2: | |||||||||
| City: | MUNDELEIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600602419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479707099 | ||||||||
| FaxNumber: | 8479707719 | ||||||||
| Practice Location | |||||||||
| Address1: | 511 E HAWLEY ST | ||||||||
| Address2: | |||||||||
| City: | MUNDELEIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600602419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479707099 | ||||||||
| FaxNumber: | 8479707719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2007 | ||||||||
| LastUpdateDate: | 03/28/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 070-007929 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | IL6697020 | 01 | IL | MEDICARE | OTHER | IL6237022 | 01 | IL | MEDICARE | OTHER | IL6238022 | 01 | IL | MEDICARE | OTHER |