Provider Demographics
NPI:1457460727
Name:JOSSART, JOEL
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:JOSSART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-8585
Mailing Address - Country:US
Mailing Address - Phone:847-741-2705
Mailing Address - Fax:
Practice Address - Street 1:891 S RANDALL RD # 893
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-3002
Practice Address - Country:US
Practice Address - Phone:847-742-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist