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NPI Code Detail

MEDICARE: MRS. CHRISTINA ELIZABETH KENRON PT

MEDICARE:  MRS. CHRISTINA ELIZABETH KENRON  PT
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
1225100000XPhysical TherapistIL

General Provider Information

NPI Number : 1598819039
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA ELIZABETH KENRON PT
Provider Business Mailing Address
First Line : 9436 OZARK AVE
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-1063
Country : US
Telephone Number : 847-791-1505
Fax Number : 847-966-1505
Provider Business Practice Location Address
First Line : 9436 OZARK AVE
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-1063
Country : US
Telephone Number : 847-791-1505
Fax Number : 847-966-1505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. CHRISTINA ELIZABETH KENRON PT” Practice Location

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