Provider Demographics
NPI:1194459685
Name:SILVERTHORN, PAIGE ELIZABETH (PTA)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:SILVERTHORN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 COMPASS RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8001
Mailing Address - Country:US
Mailing Address - Phone:636-329-0110
Mailing Address - Fax:
Practice Address - Street 1:BETHESDA SOUTHGATE
Practice Address - Street 2:322 OLD STATE RD
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63021
Practice Address - Country:US
Practice Address - Phone:636-227-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015036919208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation