Provider Demographics
NPI:1639880552
Name:DPRA THERAPEUTICS LLC
Entity Type:Organization
Organization Name:DPRA THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:SHEILA
Authorized Official - Last Name:RACADIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-638-6234
Mailing Address - Street 1:9422 BAY COLONY DR APT 2W
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-3634
Mailing Address - Country:US
Mailing Address - Phone:708-638-6234
Mailing Address - Fax:
Practice Address - Street 1:3630 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2792
Practice Address - Country:US
Practice Address - Phone:708-638-6234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty