Provider Demographics
NPI:1609753615
Name:GREENBLATT, MADELEINE WEIL (PT, DPT)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:WEIL
Last Name:GREENBLATT
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 1:2350 N LINCOLN PARK W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6074
Mailing Address - Country:US
Mailing Address - Phone:773-358-0427
Mailing Address - Fax:
Practice Address - Street 1:1919 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7246
Practice Address - Country:US
Practice Address - Phone:773-358-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.029325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist