Individual
CHRISTOPHER WAYNE WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1513 DEKALB AVE, SYCAMORE, IL 60178-2703
(815) 758-0000
(815) 991-9484
Mailing address
1952 ABERDEEN CT, SYCAMORE, IL 60178-3175
(815) 758-0000
(815) 748-3014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-010201
IL
2251X0800X
Orthopedic Physical Therapist
Primary
070-010201
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355618097001
—
IL
Enumeration date
08/20/2006
Last updated
03/17/2018
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