Provider Demographics
NPI:1528254703
Name:DIAMANTE, CELESTE (PT)
Entity type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:
Last Name:DIAMANTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3900 W 95TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-1922
Mailing Address - Country:US
Mailing Address - Phone:708-423-7799
Mailing Address - Fax:708-423-7923
Practice Address - Street 1:4709 GOLF RD
Practice Address - Street 2:SUITE 550
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1231
Practice Address - Country:US
Practice Address - Phone:847-676-1212
Practice Address - Fax:847-676-1217
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist