Provider Demographics
NPI:1063579738
Name:AMIN, SWATI R (LPT)
Entity type:Individual
Prefix:
First Name:SWATI
Middle Name:R
Last Name:AMIN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 BAY SCOTT CIR
Mailing Address - Street 2:STE. #105
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1108
Mailing Address - Country:US
Mailing Address - Phone:630-922-0050
Mailing Address - Fax:630-922-0574
Practice Address - Street 1:1879 BAY SCOTT CIR
Practice Address - Street 2:STE. #105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1108
Practice Address - Country:US
Practice Address - Phone:630-922-0050
Practice Address - Fax:630-922-0574
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232236OtherBCBS OF IL
IL02232236OtherBCBS OF IL
ILPO0126091Medicare PIN