Provider Demographics
NPI:1790352458
Name:ZEBOLD, JAMES ROBERT (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:ZEBOLD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416501
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-7594
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:111 N LARKIN AVE STE C
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-7833
Practice Address - Country:US
Practice Address - Phone:779-970-5100
Practice Address - Fax:779-221-8087
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070025951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist