Provider Demographics
NPI:1376727271
Name:WEISENSEE, CHRISTINE J (PTA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:J
Last Name:WEISENSEE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:J
Other - Last Name:JAMROSZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1305 S MICHIGAN AVE
Mailing Address - Street 2:APT 1612
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 DESPLAINES AVENUE
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130
Practice Address - Country:US
Practice Address - Phone:708-366-2442
Practice Address - Fax:708-366-0179
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant