Provider Demographics
NPI:1851696108
Name:THAKKAR, VIMMI KUMARI (DPT)
Entity Type:Individual
Prefix:
First Name:VIMMI
Middle Name:KUMARI
Last Name:THAKKAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:VIMMI
Other - Middle Name:KUMARI
Other - Last Name:AGGARWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 N COLUMBUS DR APT 4102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7967
Mailing Address - Country:US
Mailing Address - Phone:630-728-7176
Mailing Address - Fax:
Practice Address - Street 1:222 N COLUMBUS DR APT 4102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7967
Practice Address - Country:US
Practice Address - Phone:630-728-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist