Provider Demographics
NPI:1700986221
Name:GEIMER, MICHAEL K (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:K
Last Name:GEIMER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1411
Mailing Address - Country:US
Mailing Address - Phone:847-298-7024
Mailing Address - Fax:847-298-7155
Practice Address - Street 1:1550 N NORTHWEST HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1411
Practice Address - Country:US
Practice Address - Phone:847-298-3079
Practice Address - Fax:847-298-4019
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070002477225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202735OtherPTAN LOCALITY 15
IL604530OtherPTAN LOCALITY 16
IL215827OtherPTAN LOCALITY 99