MEDICARE: MS. KASHA A WEINSHENK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070016001	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	205086004	OTHER	IL	MEDICARE
3	539320004	OTHER	IL	MEDICARE
4	CH9748	OTHER	IL	RAILROAD MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	070016001	OTHER	IL	IL PT LICENSE

General Provider Information

NPI Number	:	1114114006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KASHA A WEINSHENK DPT

Provider Business Mailing Address
First Line	:	33900 HARPER AVE
Second Line	:	SUITE 104
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48035-4258
Country	:	US
Telephone Number	:	586-350-2644
Fax Number	:	586-541-3735

Provider Business Practice Location Address
First Line	:	2028 OAKTON ST
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1958
Country	:	US
Telephone Number	:	847-993-8020
Fax Number	:	847-993-8018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	04/01/2024

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