Provider Demographics
NPI:1184013096
Name:BADMAN, JEAN (DPT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:BADMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:113 S EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3519
Practice Address - Country:US
Practice Address - Phone:815-334-0400
Practice Address - Fax:815-334-0800
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60831225100000X
MN9415225100000X
CA42133225100000X
TX1238483225100000X
IL070022307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist