| Ethan David, PT, DPT | |
|
23915 W Main St Unit 109, Plainfield, IL 60544-1993 | |
| (815) 296-0596 | |
| Not Available |
| Full Name | Ethan David |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Location | 23915 W Main St Unit 109, Plainfield, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972433993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070.039858 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Physical Therapy And Wellness Pllc | 4981055852 | 6 |
| Provider Name | Legacy Physical Therapy and Wellness PLLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1992585095 PECOS PAC ID: 4981055852 Enrollment ID: O20240105000182 |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan David, PT, DPT 11016 Haley Ct, Orland Park, IL 60467-5667 Ph: Not Available | Ethan David, PT, DPT 23915 W Main St Unit 109, Plainfield, IL 60544-1993 Ph: (815) 296-0596 |
Shannon Patricia Gengenbacher, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 14731 S Van Dyke Rd, Plainfield, IL 60544 Phone: 815-267-3196 |
Willow Home Care, Ltd Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13246 S Route 59 Ste 102, Plainfield, IL 60585 Phone: 815-230-3910 Fax: 815-230-3930 |
Rohini Deshpande, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 13311 S Route 59, Plainfield, IL 60585 Phone: 815-577-2488 Fax: 815-577-2489 |
Donald Novakowski, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 16108 Illinois Rte 59, Ste 132, Plainfield, IL 60586 Phone: 331-299-5422 |
Legacy Physical Therapy And Wellness Pllc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 23915 W Main St Unit 109, Plainfield, IL 60544 Phone: 630-235-4433 |
Jill Hill, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 16108 S Rte 59, Plainfield, IL 60586 Phone: 630-967-2000 |
Tiffany Janyee Crutcher, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 23915 W Main St, Suite A, Plainfield, IL 60544 Phone: 815-609-0570 Fax: 815-609-1026 |