Provider Demographics
NPI:1750317541
Name:MCNEIL, DARRYL JOHN (PT,MTC)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:JOHN
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:PT,MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7105
Mailing Address - Country:US
Mailing Address - Phone:630-820-8963
Mailing Address - Fax:630-851-5008
Practice Address - Street 1:4000 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7105
Practice Address - Country:US
Practice Address - Phone:630-820-8963
Practice Address - Fax:630-851-5008
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist