Provider Demographics
NPI:1578706222
Name:DE VEYRA, FARRAH (PT)
Entity Type:Individual
Prefix:
First Name:FARRAH
Middle Name:
Last Name:DE VEYRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FARRAH
Other - Middle Name:
Other - Last Name:JALECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3963 W BELMONT AVE UNIT 342
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4638
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3963 W BELMONT UNIT 342
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4638
Practice Address - Country:US
Practice Address - Phone:224-717-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist