Healthcare Provider Details

I. General information

NPI: 1306783477
Provider Name (Legal Business Name): KATHRYN POTRATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE POTRATZ

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 MOON LAKE BLVD STE 140
HOFFMAN ESTATES IL
60169-1070
US

IV. Provider business mailing address

1721 MOON LAKE BLVD STE 140
HOFFMAN ESTATES IL
60169-1070
US

V. Phone/Fax

Practice location:
  • Phone: 847-345-9997
  • Fax:
Mailing address:
  • Phone: 847-345-9997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-398425
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: