Provider Demographics
NPI:1972226801
Name:BEETCHER, SAVANNAH ALEXANDRA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ALEXANDRA
Last Name:BEETCHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 COMMERCE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8865
Mailing Address - Country:US
Mailing Address - Phone:630-933-1500
Mailing Address - Fax:331-732-4581
Practice Address - Street 1:1001 COMMERCE DR STE 600
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-8865
Practice Address - Country:US
Practice Address - Phone:630-933-1500
Practice Address - Fax:331-732-4581
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070026899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist