Provider Demographics
NPI:1649349432
Name:WESTRICH, AMY S (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:WESTRICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8681 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-7271
Mailing Address - Country:US
Mailing Address - Phone:618-982-9413
Mailing Address - Fax:
Practice Address - Street 1:3308 LOGAN DR
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3759
Practice Address - Country:US
Practice Address - Phone:618-993-4024
Practice Address - Fax:618-993-1570
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK34547Medicare PIN