Provider Demographics
NPI:1396925566
Name:FALCUS, JOHN (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:FALCUS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BRIDLEPATH DR
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-7961
Mailing Address - Country:US
Mailing Address - Phone:847-209-8434
Mailing Address - Fax:847-245-3234
Practice Address - Street 1:27 BRIDLEPATH DR
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-7961
Practice Address - Country:US
Practice Address - Phone:847-209-8434
Practice Address - Fax:847-245-3234
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist