Provider Demographics
NPI:1679772990
Name:L'ABBE, JOSEPH RICHARD (PT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RICHARD
Last Name:L'ABBE
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 1:511 E HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-2419
Mailing Address - Country:US
Mailing Address - Phone:847-970-7099
Mailing Address - Fax:847-970-7719
Practice Address - Street 1:511 E HAWLEY ST
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-2419
Practice Address - Country:US
Practice Address - Phone:847-970-7099
Practice Address - Fax:847-970-7719
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-007929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6697020OtherMEDICARE
ILIL6237022OtherMEDICARE
ILIL6238022OtherMEDICARE