Provider Demographics
NPI:1760422844
Name:BEESE, JAMES J (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:BEESE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:7130 W 127TH ST
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1560
Practice Address - Country:US
Practice Address - Phone:708-361-0033
Practice Address - Fax:708-361-0066
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006094A225100000X
IL070004781225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK30652Medicare PIN
IL650021512Medicare PIN
IL650019737Medicare PIN
ILP00363905Medicare PIN
ILK16538Medicare PIN