Provider Demographics
NPI:1134475312
Name:ATUN, DOBEN FERRER (PT)
Entity type:Individual
Prefix:MRS
First Name:DOBEN
Middle Name:FERRER
Last Name:ATUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16089 POPPYSEED CIR
Mailing Address - Street 2:UNIT 2008
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6314
Mailing Address - Country:US
Mailing Address - Phone:561-496-7993
Mailing Address - Fax:561-496-0589
Practice Address - Street 1:8545 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1974
Practice Address - Country:US
Practice Address - Phone:773-606-1764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.017839225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070.017839OtherILLINOIS PROFESSIONAL REGULATION PT LICENSE NUMBER
IL208325009Medicare PIN