Individual
MICHAEL J HERLIHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2835 N GRANDVIEW BLVD STE 100, PEWAUKEE, WI 53072-5546
(262) 574-1100
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05010782A
IN
225100000X
Physical Therapist
070017165
IL
225100000X
Physical Therapist
Primary
12772-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100039803
—
WI
05
—
100288649
—
WI
01
—
P00931570
MEDICARE RAILROAD
IL
Enumeration date
05/11/2009
Last updated
09/19/2024
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