Provider Demographics
NPI:1477229474
Name:PHILIPP, TAYLOR MARIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:MARIE
Last Name:PHILIPP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35W356 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1268
Mailing Address - Country:US
Mailing Address - Phone:630-779-8181
Mailing Address - Fax:
Practice Address - Street 1:3351 HOBSON RD STE B
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1689
Practice Address - Country:US
Practice Address - Phone:630-541-3652
Practice Address - Fax:630-559-1525
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.025999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist