Provider Demographics
NPI:1609124254
Name:DELGADO, COURTENAY BRIGHTMAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:COURTENAY
Middle Name:BRIGHTMAN
Last Name:DELGADO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:COURTENAY
Other - Middle Name:ELIZABETH
Other - Last Name:BRIGHTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3541 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60203-1603
Mailing Address - Country:US
Mailing Address - Phone:847-738-0305
Mailing Address - Fax:
Practice Address - Street 1:1401 S CALIFORNIA
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608
Practice Address - Country:US
Practice Address - Phone:773-522-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist