Provider Demographics
NPI:1679593230
Name:PALMIERI, MICHAEL EUGENE (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:PALMIERI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 N MILWAUKEE AVE
Mailing Address - Street 2:APT 107
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1341
Mailing Address - Country:US
Mailing Address - Phone:435-817-8100
Mailing Address - Fax:
Practice Address - Street 1:1479 N MILWAUKEE AVE
Practice Address - Street 2:APT 107
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1341
Practice Address - Country:US
Practice Address - Phone:435-817-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070004199225100000X
UT3720702401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist