1679145676 NPI number — DR. MARY K. WILHELMI DPT

Table of content: DR. MARY K. WILHELMI DPT (NPI 1679145676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679145676 NPI number — DR. MARY K. WILHELMI DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILHELMI
Provider First Name:
MARY
Provider Middle Name:
K.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KLADIS
Provider Other First Name:
MARY
Provider Other Middle Name:
K.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679145676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2310 MOHAWK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENVIEW
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60026-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-849-0856
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7208 E CAVE CREEK RD UNIT H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAREFREE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85377-9660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-488-9095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  LPT-31799 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)