Provider Demographics
NPI:1811397904
Name:TOOMBS, DENISE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:TOOMBS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 S LAKE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2130
Mailing Address - Country:US
Mailing Address - Phone:773-456-7142
Mailing Address - Fax:
Practice Address - Street 1:4850 S LAKE PARK AVE APT 911
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2047
Practice Address - Country:US
Practice Address - Phone:773-456-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.020896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist