Provider Demographics
NPI:1164767323
Name:BREGER, JOSHUA (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BREGER
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 1:206 ALBERT SABIN WAY RM 1021
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-2800
Mailing Address - Country:US
Mailing Address - Phone:847-530-2700
Mailing Address - Fax:
Practice Address - Street 1:1847 OAK ST
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3013
Practice Address - Country:US
Practice Address - Phone:847-441-7460
Practice Address - Fax:847-441-7465
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019600225100000X
OHPT019049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist