Provider Demographics
NPI:1699268144
Name:HOUGHTAYLEN, NATALIE ANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNE
Last Name:HOUGHTAYLEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:WOJDYLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:5100 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4671
Practice Address - Country:US
Practice Address - Phone:630-967-2000
Practice Address - Fax:708-398-6869
Is Sole Proprietor?:No
Enumeration Date:2018-06-10
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist