Provider Demographics
NPI:1124539184
Name:VILME, NINA M (DPT)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:M
Last Name:VILME
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:M
Other - Last Name:ZAKHARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:1744 E LAKE ST
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-4810
Practice Address - Country:US
Practice Address - Phone:630-246-4063
Practice Address - Fax:630-246-4195
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist