Provider Demographics
NPI:1437783263
Name:CANTAL, JON ALEX (DPT)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:ALEX
Last Name:CANTAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:JON ALEX
Other - Middle Name:CRUZ
Other - Last Name:CANTAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:4370 BLUE DIAMOND RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7787
Practice Address - Country:US
Practice Address - Phone:702-443-9301
Practice Address - Fax:702-342-0600
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist