Provider Demographics
NPI:1487965745
Name:HARMENING, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HARMENING
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:PO BOX 66530
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60666-0530
Mailing Address - Country:US
Mailing Address - Phone:708-326-1700
Mailing Address - Fax:773-337-9106
Practice Address - Street 1:11528 W 183RD ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9467
Practice Address - Country:US
Practice Address - Phone:708-326-1700
Practice Address - Fax:773-337-9106
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070018143OtherLICENSE