Provider Demographics
NPI:1780023358
Name:HOSEY, AMBER KAYE (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:KAYE
Last Name:HOSEY
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 1:722 N MCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-1429
Mailing Address - Country:US
Mailing Address - Phone:847-695-5088
Mailing Address - Fax:847-695-5102
Practice Address - Street 1:722 N MCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-1429
Practice Address - Country:US
Practice Address - Phone:847-695-5088
Practice Address - Fax:847-695-5102
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37702225100000X
IL070-020606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist