Provider Demographics
NPI:1720057250
Name:FERRY BIONDI, MARTHA (PT)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:
Last Name:FERRY BIONDI
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 1:480 ELM PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2538
Mailing Address - Country:US
Mailing Address - Phone:847-926-9355
Mailing Address - Fax:847-926-8955
Practice Address - Street 1:480 ELM PL
Practice Address - Street 2:SUITE 103
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2538
Practice Address - Country:US
Practice Address - Phone:847-926-9355
Practice Address - Fax:847-926-8955
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X, 2251E1200X, 2251N0400X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004932465OtherBLUE CROSS BLUE SHIELD
IL0004932465OtherBLUE CROSS BLUE SHIELD