Provider Demographics
NPI:1487132841
Name:VERSLUYS, HANNAH E (DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:E
Last Name:VERSLUYS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:E
Other - Last Name:WEATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:10030 W 130TH LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-8582
Mailing Address - Country:US
Mailing Address - Phone:630-999-4958
Mailing Address - Fax:
Practice Address - Street 1:12800 MISSISSIPPI PKWY STE A102
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6901
Practice Address - Country:US
Practice Address - Phone:219-662-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-29
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2255A2300X, 225100000X
IA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer