Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TRAIRUD-JACK WATANACHAIYOT, D.P.T.
DeactivatedMR. TRAIRUD-JACK WATANACHAIYOT, D.P.T. is a Physical Therapy Assistant healthcare provider located in WESTERN SPRINGS, Illinois. NPI 1811328461 is deactivated in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · WESTERN SPRINGS, IL
This NPI has been deactivated.
The record was deactivated on June 2, 2022.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1811328461
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 9, 2013 (8.4794520547945 yrs)
- Last Updated
- Sep 23, 2022
- Deactivated
- Jun 2, 2022
- Licenses
-
29013 (NY)070-025183 (IL)
Practice Information
- Address
-
4700 GILBERT AVE STE 43AWESTERN SPRINGS, IL, 605581670Browse IL providers · Browse ZIP 60558
- Phone
- 7087831044
- Fax
- 7087831048
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
Other Physical Therapy Assistant Providers in WESTERN SPRINGS, IL
| Name | Credential | NPI |
|---|---|---|
| MR. TIMOTHY DALE KISNER | M.P.T. | 1689650004 |
| CRAIG JAMES MAWDSLEY | DPT, COMT, FAAOMPT | 1003832387 |
| AMY WATERWALL | MPT, CEAS | 1124128053 |
| DANIEL JOSEPH KING | P.T. | 1255410254 |
| LUCIE D CASIELLO | MPT | 1245493691 |
| RACHEL SCREMENTI | PT | 1649578097 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.