Provider Demographics
NPI:1932897337
Name:HEADLEE, BAILEY M (DPT)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:M
Last Name:HEADLEE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:M
Other - Last Name:VOLMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:4731 E GREENWAY RD STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4817
Practice Address - Country:US
Practice Address - Phone:602-661-8956
Practice Address - Fax:602-281-7145
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist