Basic Information
| Provider Information | |||||||||
| NPI: | 1164141743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUDDY | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11914 ILLINOIS RTE 59 | ||||||||
| Address2: | SUITE 134 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303810496 | ||||||||
| FaxNumber: | 8156769090 | ||||||||
| Practice Location | |||||||||
| Address1: | 11914 ILLINOIS RTE 59 | ||||||||
| Address2: | SUITE 134 | ||||||||
| City: | PLAINFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303810496 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2022 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.