Provider Demographics
NPI:1447570767
Name:VILLAESTER, TROY V (PT)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:V
Last Name:VILLAESTER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:CESAR
Other - Middle Name:
Other - Last Name:VILLAESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:550 FRONTAGE RD
Mailing Address - Street 2:SUITE 2415
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1202
Mailing Address - Country:US
Mailing Address - Phone:847-441-5593
Mailing Address - Fax:847-441-0734
Practice Address - Street 1:620 WARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5446
Practice Address - Country:US
Practice Address - Phone:217-446-0660
Practice Address - Fax:217-446-9839
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.015287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist