Provider Demographics
NPI:1346538261
Name:WEILER, LINDSAY VIRGINIA (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:VIRGINIA
Last Name:WEILER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:VIRGINIA
Other - Last Name:WHIPPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:3155 W CRAIG RD STE 120-140
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0782
Practice Address - Country:US
Practice Address - Phone:702-639-2333
Practice Address - Fax:702-639-2334
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251S0007X, 2251X0800X
AZ9362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ116913Medicaid