Provider Demographics
NPI:1265931273
Name:THIRUNELLIPARAMBIL, JAMES (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:THIRUNELLIPARAMBIL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 LAKE COOK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4909
Mailing Address - Country:US
Mailing Address - Phone:847-858-5172
Mailing Address - Fax:
Practice Address - Street 1:707 LAKE COOK RD STE 120
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4909
Practice Address - Country:US
Practice Address - Phone:847-858-5172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist