Provider Demographics
NPI:1699110965
Name:YALAMANCHILI, UMA (PT)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:
Last Name:YALAMANCHILI
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 1:1001 CENTURION LN
Mailing Address - Street 2:APT 2
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1146
Mailing Address - Country:US
Mailing Address - Phone:224-475-1678
Mailing Address - Fax:
Practice Address - Street 1:1655 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 101 W
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3976
Practice Address - Country:US
Practice Address - Phone:847-305-3610
Practice Address - Fax:847-770-4458
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist