Provider Demographics
NPI:1972551273
Name:GREENHILL, DANIEL P (MPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:GREENHILL
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1738 165TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-2821
Practice Address - Country:US
Practice Address - Phone:219-844-1782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007758A225100000X
IL070013223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00943090OtherMEDCIARE RAILROAD
INM400048739Medicare PIN
IL216859101Medicare PIN