Provider Demographics
NPI:1720334253
Name:MANES, ESTHER (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:MANES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 S MILWAUKEE AVE APT F
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3240
Mailing Address - Country:US
Mailing Address - Phone:224-595-6044
Mailing Address - Fax:
Practice Address - Street 1:622 S MILWAUKEE AVE APT F
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3240
Practice Address - Country:US
Practice Address - Phone:224-595-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist