Provider Demographics
NPI:1316259484
Name:LINDSTROM, JOEL D (DPT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:LINDSTROM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:640-575-1980
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:3131 CUSTER RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-2083
Practice Address - Country:US
Practice Address - Phone:214-427-1541
Practice Address - Fax:214-817-4052
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60160972225100000X
TX1214033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60160972OtherPHYSICAL THERAPY LICENSE
WAG8893444Medicare PIN
WA60160972OtherPHYSICAL THERAPY LICENSE