Provider Demographics
NPI:1558558817
Name:WASILCHUK, VALERIE LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:WASILCHUK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 COMMERCE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8865
Mailing Address - Country:US
Mailing Address - Phone:331-732-4580
Mailing Address - Fax:331-732-4581
Practice Address - Street 1:1001 COMMERCE DR STE 600
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-8865
Practice Address - Country:US
Practice Address - Phone:331-732-4580
Practice Address - Fax:331-732-4581
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-017821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist