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General NPI Number Information
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NPI Number | 1588464010
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Entity Type | Individual
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Provider Name | RACHEL MARIE KIRKOLIS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 440
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City | CHICAGO
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State | IL
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Zip | 60612-3836
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Country | US
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Telephone | 708-929-8661
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Fax |
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Provider Business Mailing Address
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Address Line | 25122 W SIOUX DR
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City | CHANNAHON
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State | IL
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Zip | 60410-3175
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Country | US
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Telephone | 708-929-8661
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070028970
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License Number State | IL
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