Provider Demographics
NPI:1528180239
Name:RIPPELMEYER, DUSTY JILL (PT, MPT, MS, GCS,NCS)
Entity Type:Individual
Prefix:MS
First Name:DUSTY
Middle Name:JILL
Last Name:RIPPELMEYER
Suffix:
Gender:F
Credentials:PT, MPT, MS, GCS,NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 N PAULINA ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2740
Mailing Address - Country:US
Mailing Address - Phone:773-559-5312
Mailing Address - Fax:
Practice Address - Street 1:1945 W WILSON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5255
Practice Address - Country:US
Practice Address - Phone:312-238-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist