Provider Demographics
NPI:1588013270
Name:WEIGAND, HALEY (DPT)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:WEIGAND
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 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-503-2644
Mailing Address - Fax:586-541-3735
Practice Address - Street 1:2116 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-1713
Practice Address - Country:US
Practice Address - Phone:312-284-1100
Practice Address - Fax:312-284-1104
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070022238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist