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General NPI Number Information
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NPI Number | 1104739739
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Entity Type | Individual
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Provider Name | ELISE KRATKOCZKI DPT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1095 PINGREE RD STE 209
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-1727
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Country | US
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Telephone | 847-458-8890
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Fax |
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Provider Business Mailing Address
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Address Line | 55 S VAIL AVE APT 1409
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-1876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 070.040793
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License Number State | IL
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