Provider Demographics
NPI:1902843634
Name:MUELLER, DAWN J (PT)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:J
Last Name:MUELLER
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 1:312 N STERLING ST.
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364
Mailing Address - Country:US
Mailing Address - Phone:815-672-5500
Mailing Address - Fax:815-672-5400
Practice Address - Street 1:312 N STERLING ST.
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364
Practice Address - Country:US
Practice Address - Phone:815-672-5500
Practice Address - Fax:815-672-5400
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013720225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK25559Medicare ID - Type Unspecified