Provider Demographics
NPI:1003266412
Name:CRNICH, JOSEPH A (PT, DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:CRNICH
Suffix:
Gender:M
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-9207
Mailing Address - Country:US
Mailing Address - Phone:773-270-9509
Mailing Address - Fax:773-253-4027
Practice Address - Street 1:1440 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-9207
Practice Address - Country:US
Practice Address - Phone:773-270-9509
Practice Address - Fax:773-253-4027
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070022330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist