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General NPI Number Information
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NPI Number | 1932653409
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Entity Type | Individual
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Provider Name | BABITHA KURIAKOSE
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Gender | Female
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 290 SPRINGFIELD DR STE 255
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2293
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Country | US
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Telephone | 630-924-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 9362 HAMLIN AVE
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City | DES PLAINES
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State | IL
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Zip | 60016-4240
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Country | US
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Telephone | 630-605-0338
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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 | 070021432
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License Number State | IL
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