Provider Demographics
NPI:1306862982
Name:HARTLINE, DENA LORI (PT)
Entity type:Individual
Prefix:MS
First Name:DENA
Middle Name:LORI
Last Name:HARTLINE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2828 NORTH CLARK STREET
Mailing Address - Street 2:SUITE 309 METRO SPINE AND SPORTS REHAB
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:773-525-0190
Mailing Address - Fax:773-525-0583
Practice Address - Street 1:2828 NORTH CLARK STREET
Practice Address - Street 2:SUITE 309 METRO SPINE AND SPORTS REHAB
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-525-0190
Practice Address - Fax:773-525-0583
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-006089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist