Provider Demographics
NPI:1053386680
Name:HILTON, SANDRA JEAN (PT)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JEAN
Last Name:HILTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 N CLYBOURN AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4946
Mailing Address - Country:US
Mailing Address - Phone:773-747-4072
Mailing Address - Fax:773-747-4069
Practice Address - Street 1:1925 N CLYBOURN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4946
Practice Address - Country:US
Practice Address - Phone:773-747-4072
Practice Address - Fax:773-747-4069
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist