Healthcare Provider Details

I. General information

NPI: 1023929312
Provider Name (Legal Business Name): KYRA POHL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 440
CHICAGO IL
60612-3836
US

IV. Provider business mailing address

2618 N WAYNE AVE APT 1R
CHICAGO IL
60614-1275
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-2454
  • Fax:
Mailing address:
  • Phone: 517-974-3477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.029891
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: