| Doctor Name: | MS. DIANE MARIE FULLER |
| NPI Number: | 1578851051 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT, PT |
| License Number: | 070018604 |
| Business Practice Address: | 901 Biesterfield Rd Suite 306 Elk Grove Village, IL - 600073392 |
| Business Phone Number: | 8474371230 |
| Business Fax Number: | 8474379023 |
| Mailing Address: | 901 Biesterfield Rd, Suite 306 ELK GROVE VILLAGE |
| State: | IL |
| Postal Code: | 600073392 |
| Phone Number: | 8474371230 |
| Fax Number: | 8474379023 |
| NPI Enumeration Date: | 07/18/2011 |
| NPI Last Update Date: | 07/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070018604 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |