Provider Demographics
NPI:1770256067
Name:ARNOLD, CHANCE (DPT)
Entity Type:Individual
Prefix:
First Name:CHANCE
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1704 MAPLE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3134
Mailing Address - Country:US
Mailing Address - Phone:630-933-1500
Mailing Address - Fax:224-271-5556
Practice Address - Street 1:1704 MAPLE AVE STE 110
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3134
Practice Address - Country:US
Practice Address - Phone:630-933-1500
Practice Address - Fax:224-271-5556
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2255A2300X
IL070027705225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer