Provider Demographics
NPI:1730397449
Name:HUGHES, ERIC S (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 N KENMORE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3367
Mailing Address - Country:US
Mailing Address - Phone:309-258-1116
Mailing Address - Fax:312-489-2357
Practice Address - Street 1:4001 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2110
Practice Address - Country:US
Practice Address - Phone:309-258-1116
Practice Address - Fax:312-489-2357
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist