Provider Demographics
NPI:1992154884
Name:MCKENNEY, ELIZABETH MARY (DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY
Last Name:MCKENNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MARY
Other - Last Name:DEPALMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
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:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:5060 BRADENTON AVE STE C
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3511
Practice Address - Country:US
Practice Address - Phone:614-961-4966
Practice Address - Fax:614-907-7297
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist