Provider Demographics
NPI:1063450724
Name:LEMBERT, DARIUS (PT)
Entity Type:Individual
Prefix:
First Name:DARIUS
Middle Name:
Last Name:LEMBERT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7706 W TOUHY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-4200
Mailing Address - Country:US
Mailing Address - Phone:773-775-1443
Mailing Address - Fax:773-775-7745
Practice Address - Street 1:7706 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-4200
Practice Address - Country:US
Practice Address - Phone:773-775-1443
Practice Address - Fax:773-775-7745
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070011867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211468Medicare PIN