Provider Demographics
NPI:1215125240
Name:VEIT, CAROL ANN (PT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:VEIT
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 1:1614 SYMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RANTOUL
Mailing Address - State:IL
Mailing Address - Zip Code:61866-3532
Mailing Address - Country:US
Mailing Address - Phone:217-892-9591
Mailing Address - Fax:
Practice Address - Street 1:1614 SYMINGTON RD
Practice Address - Street 2:
Practice Address - City:RANTOUL
Practice Address - State:IL
Practice Address - Zip Code:61866-3532
Practice Address - Country:US
Practice Address - Phone:217-892-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX062729101Medicaid