Provider Demographics
NPI:1285035410
Name:ELWELL, CHRISTOPHER AARON (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:ELWELL
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:
Mailing Address - Fax:
Practice Address - Street 1:7224 118TH AVE STE E
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-8424
Practice Address - Country:US
Practice Address - Phone:262-857-4400
Practice Address - Fax:262-857-4411
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01571100225100000X
WI12988-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist