1760606362 NPI number — APRIL LYNN NEUKAM PT, DPT, OCS

Table of content: APRIL LYNN NEUKAM PT, DPT, OCS (NPI 1760606362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760606362 NPI number — APRIL LYNN NEUKAM PT, DPT, OCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEUKAM
Provider First Name:
APRIL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, OCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760606362
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17W745 BUTTERFIELD RD
Provider Second Line Business Mailing Address:
SUITE AB
Provider Business Mailing Address City Name:
OAKBROOK TERRACE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60181-4277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-639-1839
Provider Business Mailing Address Fax Number:
630-597-2501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17W745 BUTTERFIELD RD
Provider Second Line Business Practice Location Address:
SUITE AB
Provider Business Practice Location Address City Name:
OAKBROOK TERRACE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60181-4277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-639-1839
Provider Business Practice Location Address Fax Number:
630-597-2501
Provider Enumeration Date:
04/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  10796-24 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 070-017662 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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