Provider Demographics
NPI:1922661586
Name:STEVENSON, EMMA GERALDINE (DPT)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:GERALDINE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:GERALDINE
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:0N321 COUNTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1889
Mailing Address - Country:US
Mailing Address - Phone:630-212-9494
Mailing Address - Fax:
Practice Address - Street 1:1535 PARK AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1657
Practice Address - Country:US
Practice Address - Phone:303-232-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090171225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic