Provider Demographics
NPI:1922563279
Name:OSTERMAN, DANIELLE M
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:OSTERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 N ASHBURY AVE
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1202
Mailing Address - Country:US
Mailing Address - Phone:630-739-9315
Mailing Address - Fax:
Practice Address - Street 1:532 N ASHBURY AVE
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1202
Practice Address - Country:US
Practice Address - Phone:630-739-9315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer