Provider Demographics
NPI:1124131313
Name:DEGREGORIO, HEATHER KATTLEMAN (PT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATTLEMAN
Last Name:DEGREGORIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:KATTLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:533 W NORTH AVE
Mailing Address - Street 2:SUITE 50
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2135
Mailing Address - Country:US
Mailing Address - Phone:630-832-6919
Mailing Address - Fax:630-832-6928
Practice Address - Street 1:800 S WELLS ST
Practice Address - Street 2:SUITE M5
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4529
Practice Address - Country:US
Practice Address - Phone:312-431-7961
Practice Address - Fax:312-431-7644
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist