Provider Demographics
NPI:1144651241
Name:ESTES, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ESTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W WOODSTOCK ST
Mailing Address - Street 2:STE A
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4239
Mailing Address - Country:US
Mailing Address - Phone:815-893-9075
Mailing Address - Fax:844-462-9452
Practice Address - Street 1:1600 16TH ST
Practice Address - Street 2:T14
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1302
Practice Address - Country:US
Practice Address - Phone:630-572-9700
Practice Address - Fax:630-572-0706
Is Sole Proprietor?:No
Enumeration Date:2013-11-29
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist