Provider Demographics
NPI:1063814267
Name:VAN ZEE, ABIGAIL ROSE (DPT)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:ROSE
Last Name:VAN ZEE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ROSE
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7814 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3536
Mailing Address - Country:US
Mailing Address - Phone:708-456-2322
Mailing Address - Fax:708-456-2395
Practice Address - Street 1:7814 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-3536
Practice Address - Country:US
Practice Address - Phone:708-456-2322
Practice Address - Fax:708-456-2395
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070021107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist