Provider Demographics
NPI:1184848988
Name:WEYRICH, CRAIG D (PT)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:D
Last Name:WEYRICH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 ESSINGTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8408
Mailing Address - Country:US
Mailing Address - Phone:815-744-7108
Mailing Address - Fax:
Practice Address - Street 1:1240 ESSINGTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8408
Practice Address - Country:US
Practice Address - Phone:815-744-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700090762251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1619980OtherBCBS OF IL
IL568150Medicare PIN
IL568080Medicare PIN
IL213760Medicare UPIN
IL567700Medicare PIN