Provider Demographics
NPI:1144901836
Name:OSBORNE, BETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:LANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:15720 S ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2693
Mailing Address - Country:US
Mailing Address - Phone:630-312-3320
Mailing Address - Fax:
Practice Address - Street 1:15720 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2693
Practice Address - Country:US
Practice Address - Phone:630-312-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist