Provider Demographics
NPI:1083081327
Name:DEBIASI, BRIANNA N (DPT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:N
Last Name:DEBIASI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:N
Other - Last Name:DEBOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4445 W IRVING PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641
Mailing Address - Country:US
Mailing Address - Phone:630-933-1500
Mailing Address - Fax:630-933-1550
Practice Address - Street 1:4445 W IRVING PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641
Practice Address - Country:US
Practice Address - Phone:630-933-1500
Practice Address - Fax:630-933-1550
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.021623225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400245654Medicare PIN
ILF400245659Medicare PIN