Provider Demographics
NPI:1841505880
Name:VANT, AMY J (DPT)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:J
Last Name:VANT
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:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60522-0471
Mailing Address - Country:US
Mailing Address - Phone:888-960-4562
Mailing Address - Fax:630-571-6038
Practice Address - Street 1:201 E OGDEN AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3633
Practice Address - Country:US
Practice Address - Phone:888-960-4562
Practice Address - Fax:630-571-6038
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist