Provider Demographics
NPI:1053627034
Name:HILSEN, NATTINEE MARY ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:NATTINEE
Middle Name:MARY ANN
Last Name:HILSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NATTINEE
Other - Middle Name:MARY ANN
Other - Last Name:INBORIBOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3075 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5622
Mailing Address - Country:US
Mailing Address - Phone:708-223-8011
Mailing Address - Fax:708-223-8193
Practice Address - Street 1:3075 WOLF RD
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5622
Practice Address - Country:US
Practice Address - Phone:708-223-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.014088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist