Provider Demographics
NPI:1720620214
Name:PLACHNO, PAMELA (BSPT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PLACHNO
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:PASCUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:116 N 3RD ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:IL
Practice Address - Zip Code:61061-1411
Practice Address - Country:US
Practice Address - Phone:815-513-9400
Practice Address - Fax:815-732-0420
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist