| Doctor Name: | MRS. JULIE ANN WATTENBERG |
| NPI Number: | 1063438703 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.P.T., D.P.T. |
| License Number: | 070-012852 |
| Business Practice Address: | 13909 Briar Ln Plainfield, IL - 605447563 |
| Business Phone Number: | 6903193872 |
| Business Fax Number: | 8157336573 |
| Mailing Address: | 13909 Briar Ln, PLAINFIELD |
| State: | IL |
| Postal Code: | 605447563 |
| Phone Number: | 6903193872 |
| Fax Number: | 8157336573 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 04/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 070-012852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |