Provider Demographics
NPI:1306183587
Name:ABLIS, JULIUS JOSEPH RIVERA (PT/L)
Entity type:Individual
Prefix:MR
First Name:JULIUS JOSEPH
Middle Name:RIVERA
Last Name:ABLIS
Suffix:
Gender:M
Credentials:PT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 E 75TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3835
Mailing Address - Country:US
Mailing Address - Phone:773-356-9300
Mailing Address - Fax:773-721-5842
Practice Address - Street 1:2649 E 75TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3835
Practice Address - Country:US
Practice Address - Phone:773-356-9300
Practice Address - Fax:773-721-5842
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019631225100000X
CO0009468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0009468OtherPHYSICAL THERAPY LICENSE
IL070019631OtherPHYSICAL THERAPY LICENSE