Provider Demographics
NPI:1255498440
Name:HARTMAN, FAITH (PT)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:ADAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
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:630-755-6200
Mailing Address - Fax:
Practice Address - Street 1:16139 WEBER RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60435-8742
Practice Address - Country:US
Practice Address - Phone:815-836-3406
Practice Address - Fax:815-836-3404
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070011870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070-011870OtherPT STATE LICENSE #
IL146636Medicare ID - Type Unspecified