Provider Demographics
NPI:1952568941
Name:HILVERT, DEANNE (PT)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:HILVERT
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 1:1601 ROSEMARY CT
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1641
Mailing Address - Country:US
Mailing Address - Phone:219-678-0308
Mailing Address - Fax:219-979-5126
Practice Address - Street 1:1601 ROSEMARY CT
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1641
Practice Address - Country:US
Practice Address - Phone:219-678-0308
Practice Address - Fax:219-979-5126
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2006099980 AOtherFIRST STEPS PROVIDER NUMBER / LEGACY PROVIDER IDENTIFIER (LPI)