Provider Demographics
NPI:1629845656
Name:MELISSA LAYHER PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MELISSA LAYHER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-571-2688
Mailing Address - Street 1:2300 W ROSCOE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8811
Mailing Address - Country:US
Mailing Address - Phone:773-571-2688
Mailing Address - Fax:
Practice Address - Street 1:1515 W HUBBARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-6337
Practice Address - Country:US
Practice Address - Phone:630-294-3447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty