Individual
DANA S WEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
14301 S GOLDEN OAK DR, HOMER GLEN, IL 60491-9696
(708) 645-7700
Mailing address
1117 W 17TH ST, CHICAGO, IL 60608-2302
(815) 353-2072
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017186
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202421
MEDICARE GROUP ID-UNSPECIFIED
—
Enumeration date
07/15/2009
Last updated
11/07/2016
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