Healthcare Provider Details

I. General information

NPI: 1639919210
Provider Name (Legal Business Name): KATHERINE ELIZABETH DOYLE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N SHEFFIELD AVE
CHICAGO IL
60614-3936
US

IV. Provider business mailing address

1829 MAPLE AVE
NORTHBROOK IL
60062-5425
US

V. Phone/Fax

Practice location:
  • Phone: 773-389-2202
  • Fax:
Mailing address:
  • Phone: 224-545-3831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.028230
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: