Provider Demographics
NPI:1083071864
Name:STEWART, ROBERT DAVID (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:STEWART
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:17051 DALLAS PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-7109
Practice Address - Country:US
Practice Address - Phone:469-416-5250
Practice Address - Fax:469-416-5260
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1266060225100000X
NY039173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist