Provider Demographics
NPI:1588056659
Name:WEBER, KAYLEE (DPT)
Entity type:Individual
Prefix:DR
First Name:KAYLEE
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:KAYLEE
Other - Middle Name:
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:15 APEX DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1282
Mailing Address - Country:US
Mailing Address - Phone:618-441-0482
Mailing Address - Fax:
Practice Address - Street 1:609 LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:GILLESPIE
Practice Address - State:IL
Practice Address - Zip Code:62033-1300
Practice Address - Country:US
Practice Address - Phone:217-280-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700212912251P0200X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics