Provider Demographics
NPI:1528114618
Name:DICLEMENTE, STEVEN JAMES (MPT, CSCS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JAMES
Last Name:DICLEMENTE
Suffix:
Gender:M
Credentials:MPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 MILL RACE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2732
Mailing Address - Country:US
Mailing Address - Phone:773-220-1617
Mailing Address - Fax:
Practice Address - Street 1:13259 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-2901
Practice Address - Country:US
Practice Address - Phone:708-597-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist