Provider Demographics
NPI:1437489408
Name:TROTTER, EMILY (PT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TROTTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:TROTTER
Other - Last Name:GIERTYCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9789 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-7723
Mailing Address - Country:US
Mailing Address - Phone:708-906-7565
Mailing Address - Fax:708-995-5679
Practice Address - Street 1:9789 CAMBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-7723
Practice Address - Country:US
Practice Address - Phone:708-906-7565
Practice Address - Fax:708-995-5679
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070003930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist