Provider Demographics
NPI:1205109162
Name:TAYLOR, APRIL MICHELLE (DPT)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:MICHELLE
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2129
Mailing Address - Country:US
Mailing Address - Phone:773-770-2419
Mailing Address - Fax:773-248-5732
Practice Address - Street 1:1320 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-770-2419
Practice Address - Fax:773-248-5732
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012004497225100000X
IL070.019781225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO140380015Medicare PIN
991643004Medicare PIN