Provider Demographics
NPI:1386015659
Name:IKANOVIC, ARMAN (DPT)
Entity Type:Individual
Prefix:
First Name:ARMAN
Middle Name:
Last Name:IKANOVIC
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 1:625 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:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:800 COLONIAL CIR
Practice Address - Street 2:#800
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9616
Practice Address - Country:US
Practice Address - Phone:515-953-1310
Practice Address - Fax:515-953-1322
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist