Provider Demographics
NPI:1255756847
Name:DARLAND, PATRICIA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:DARLAND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:HOEG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-1932
Mailing Address - Fax:630-928-5032
Practice Address - Street 1:23800 ORCHARD LAKE RD
Practice Address - Street 2:STE 101
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2560
Practice Address - Country:US
Practice Address - Phone:248-474-5516
Practice Address - Fax:248-474-5519
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP01368858Medicare PIN
MIMI6211129Medicare PIN
MIN69750099Medicare PIN