Provider Demographics
NPI:1285670372
Name:HITCHCOCK, BILL R (PT)
Entity Type:Individual
Prefix:MR
First Name:BILL
Middle Name:R
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:PT
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:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:326 N MICHIGAN AVE
Practice Address - Street 2:#324
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3714
Practice Address - Country:US
Practice Address - Phone:312-229-5271
Practice Address - Fax:312-578-0795
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001006A225100000X
IL070.018867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist