Provider Demographics
NPI:1871739334
Name:WINDMOELLER, MAUREEN COYLE (PT)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:COYLE
Last Name:WINDMOELLER
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 1:9649 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-3632
Mailing Address - Country:US
Mailing Address - Phone:708-352-3580
Mailing Address - Fax:708-352-9728
Practice Address - Street 1:9649 W 55TH ST
Practice Address - Street 2:
Practice Address - City:COUNTRYSIDE
Practice Address - State:IL
Practice Address - Zip Code:60525-3632
Practice Address - Country:US
Practice Address - Phone:708-352-3580
Practice Address - Fax:708-352-9728
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070004727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist