Doctor Name: | HERBERT DEITERS |
NPI Number: | 1992916605 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 070015746 |
Business Practice Address: | 15750 Marian Dr Homer Glen, IL - 604916200 |
Business Phone Number: | 7086453400 |
Business Fax Number: | |
Mailing Address: | 2160 S 1st Ave, MAYWOOD |
State: | IL |
Postal Code: | 601533328 |
Phone Number: | 8885847888 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070015746 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |