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General NPI Number Information
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NPI Number | 1891036463
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Entity Type | Individual
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Provider Name | KARINA KINLEN MSOTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 1502 E MAIN ST
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City | ST CHARLES
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State | IL
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Zip | 60174-2327
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Country | US
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Telephone | 630-797-5658
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Fax | 630-797-5879
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Provider Business Mailing Address
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Address Line | PO BOX 416501 STE 140
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City | BOSTON
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State | MA
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Zip | 02241-3203
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Country | US
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Telephone | 914-294-4050
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Fax | 631-760-8306
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056008696
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License Number State | IL
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