Provider Demographics
NPI:1285121814
Name:OVERWAY, ERIN E (DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:OVERWAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:ANGLE
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:803-812-3656
Mailing Address - Fax:
Practice Address - Street 1:1155 S COLLEGE MALL RD STE A
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401
Practice Address - Country:US
Practice Address - Phone:812-558-3356
Practice Address - Fax:812-558-3377
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012991A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist