Provider Demographics
NPI:1679523815
Name:LOUGHARY, DEANNE ELLEN (PT)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:ELLEN
Last Name:LOUGHARY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:630-466-5866
Mailing Address - Fax:630-466-5869
Practice Address - Street 1:38 S MAIN ST
Practice Address - Street 2:SUITE A & B
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-5031
Practice Address - Country:US
Practice Address - Phone:630-466-5866
Practice Address - Fax:630-466-5869
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL070011442208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation