Provider Demographics
NPI:1013994474
Name:JOSHI, NAUKA B (BSC PT, CYI)
Entity type:Individual
Prefix:MS
First Name:NAUKA
Middle Name:B
Last Name:JOSHI
Suffix:
Gender:F
Credentials:BSC PT, CYI
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:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:383 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1474
Practice Address - Country:US
Practice Address - Phone:630-924-0367
Practice Address - Fax:630-924-0375
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-006205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202845012Medicare PIN
ILIL2993002Medicare PIN
ILK46375Medicare PIN
IL214708034Medicare PIN