Provider Demographics
NPI:1952666968
Name:BOYLAND, DENNIS LEN (PHYSICAL THERAPY ASS)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:LEN
Last Name:BOYLAND
Suffix:
Gender:M
Credentials:PHYSICAL THERAPY ASS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:16541 LOCKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452
Mailing Address - Country:US
Mailing Address - Phone:708-560-0157
Mailing Address - Fax:
Practice Address - Street 1:3004 SOUTH PULASKI ROAD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623
Practice Address - Country:US
Practice Address - Phone:773-521-5300
Practice Address - Fax:773-521-5305
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.005411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist