Provider Demographics
NPI:1508515024
Name:VERMA, DIYA
Entity Type:Individual
Prefix:
First Name:DIYA
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 MUSEUM DR
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-7005
Mailing Address - Country:US
Mailing Address - Phone:708-952-8220
Mailing Address - Fax:
Practice Address - Street 1:5112 MUSEUM DR
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-7005
Practice Address - Country:US
Practice Address - Phone:708-952-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3018752251X0800X
IL0700271102251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic