Provider Demographics
NPI:1114114006
Name:WEINSHENK, KASHA A (DPT)
Entity Type:Individual
Prefix:MS
First Name:KASHA
Middle Name:A
Last Name:WEINSHENK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KASHA
Other - Middle Name:A
Other - Last Name:CHRUSCIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:586-541-3735
Practice Address - Street 1:2028 OAKTON ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1958
Practice Address - Country:US
Practice Address - Phone:847-993-8020
Practice Address - Fax:847-993-8018
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205086004OtherMEDICARE
IL070016001OtherIL PT LICENSE
IL539320004OtherMEDICARE
ILCH9748OtherRAILROAD MEDICARE GROUP PTAN