Provider Demographics
NPI:1972771244
Name:ROY, SANJOY (MPT)
Entity Type:Individual
Prefix:
First Name:SANJOY
Middle Name:
Last Name:ROY
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 1:600 S COUNTY FARM RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4575
Mailing Address - Country:US
Mailing Address - Phone:312-523-8544
Mailing Address - Fax:
Practice Address - Street 1:600 S COUNTY FARM RD STE 201
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4575
Practice Address - Country:US
Practice Address - Phone:630-446-5660
Practice Address - Fax:630-597-4850
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-014921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist