Provider Demographics
NPI:1649402579
Name:BITTMAN, DIANE K (PT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:BITTMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 GRAYHAWK DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-6324
Mailing Address - Country:US
Mailing Address - Phone:920-267-2076
Mailing Address - Fax:
Practice Address - Street 1:2001 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-1300
Practice Address - Country:US
Practice Address - Phone:847-458-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist