Provider Demographics
NPI:1427381383
Name:SALTON, BRIAN EBEN (DPT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:EBEN
Last Name:SALTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:125 LAKE COOK ROAD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089
Mailing Address - Country:US
Mailing Address - Phone:847-520-3382
Mailing Address - Fax:847-520-3404
Practice Address - Street 1:3600 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7595
Practice Address - Country:US
Practice Address - Phone:515-663-4824
Practice Address - Fax:515-663-4860
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.017238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist