Provider Demographics
NPI:1922249176
Name:MARTIN-RANFT, SALLY (PT)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:MARTIN-RANFT
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 1:512 CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2014
Mailing Address - Country:US
Mailing Address - Phone:847-682-1630
Mailing Address - Fax:
Practice Address - Street 1:960 RAND RD
Practice Address - Street 2:SUITE 113B
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2352
Practice Address - Country:US
Practice Address - Phone:847-682-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.004024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist