Provider Demographics
NPI:1790901718
Name:SLEEPER, MARK DAVID (PT, MS, OCS)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:DAVID
Last Name:SLEEPER
Suffix:
Gender:M
Credentials:PT, MS, OCS
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Mailing Address - Street 1:1417 WILLARD PL
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3701
Mailing Address - Country:US
Mailing Address - Phone:630-353-0434
Mailing Address - Fax:
Practice Address - Street 1:233 E ERIE ST
Practice Address - Street 2:SUITE 404
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2926
Practice Address - Country:US
Practice Address - Phone:312-274-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic