Provider Demographics
NPI:1487748679
Name:HOLLAR, ANTHONY CHRISTOPHER (MPT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:HOLLAR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:HOLLAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:
Practice Address - Street 1:6848 WHITESTOWN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7624
Practice Address - Country:US
Practice Address - Phone:317-489-0921
Practice Address - Fax:317-766-9091
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1269225100000X
IN05013657A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND64-12566Medicaid
ND64-12566Medicaid