Provider Demographics
NPI:1205317179
Name:OSWAL, YUTI SUBHASH (PT, MSPT, DPT)
Entity type:Individual
Prefix:MISS
First Name:YUTI
Middle Name:SUBHASH
Last Name:OSWAL
Suffix:
Gender:F
Credentials:PT, MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3048
Mailing Address - Country:US
Mailing Address - Phone:630-769-6564
Mailing Address - Fax:630-769-6151
Practice Address - Street 1:250 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3048
Practice Address - Country:US
Practice Address - Phone:630-769-6564
Practice Address - Fax:630-769-6151
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070022992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist