Provider Demographics
NPI:1144431289
Name:GEISZ, PATRICIA J (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:GEISZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 EUSTACE DR
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-1741
Mailing Address - Country:US
Mailing Address - Phone:815-285-4172
Mailing Address - Fax:
Practice Address - Street 1:215 E 1ST ST
Practice Address - Street 2:COMMERCE TOWERS, SUITE 318-319
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-3166
Practice Address - Country:US
Practice Address - Phone:815-285-5591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist