Provider Demographics
NPI:1881938264
Name:DAIGNAULT, RICHARD III (DPT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:DAIGNAULT
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:DAIGNAULT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:POB 7132960
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-0001
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:536 S YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3952
Practice Address - Country:US
Practice Address - Phone:630-967-2000
Practice Address - Fax:630-967-2350
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist