Provider Demographics
NPI:1558462267
Name:TEEMER, MYLA C (PT)
Entity Type:Individual
Prefix:MRS
First Name:MYLA
Middle Name:C
Last Name:TEEMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MYLA
Other - Middle Name:M
Other - Last Name:CATINDIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1055 EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1266
Mailing Address - Country:US
Mailing Address - Phone:847-789-5055
Mailing Address - Fax:
Practice Address - Street 1:1800 HOLLISTER DR
Practice Address - Street 2:STE 205
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5263
Practice Address - Country:US
Practice Address - Phone:847-918-7947
Practice Address - Fax:847-918-9622
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist