Provider Demographics
NPI:1871302414
Name:DZIURA, HANNAH (PT, DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:DZIURA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 S CASS AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1949
Mailing Address - Country:US
Mailing Address - Phone:708-288-1361
Mailing Address - Fax:
Practice Address - Street 1:7125 JANES AVE STE 200
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2341
Practice Address - Country:US
Practice Address - Phone:630-541-3652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.028816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist