Provider Demographics
NPI:1316411093
Name:NAUGHTON, ERICA LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 N ASHLAND AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2210
Mailing Address - Country:US
Mailing Address - Phone:440-346-0197
Mailing Address - Fax:
Practice Address - Street 1:1431 N WESTERN AVE STE 510
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1788
Practice Address - Country:US
Practice Address - Phone:773-269-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.024064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist