Provider Demographics
NPI:1518442847
Name:ROY, JULIE ANNE JOHLIE (DPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE JOHLIE
Last Name:ROY
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 1:275 W WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2499
Mailing Address - Country:US
Mailing Address - Phone:847-302-6282
Mailing Address - Fax:
Practice Address - Street 1:455 LAKE COOK RD STE W3B
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5202
Practice Address - Country:US
Practice Address - Phone:224-285-1004
Practice Address - Fax:224-285-1005
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.024026208100000X
IL070024026208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation