MEDICARE: KELSEY ZIENTY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501303296	MI
2	225100000X	Physical Therapist	070.021549	IL

General Provider Information

NPI Number	:	1184000812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY ZIENTY DPT

Provider Business Mailing Address
First Line	:	1210 E CENTRAL RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-2681
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 E CENTRAL RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-2681
Country	:	US
Telephone Number	:	847-398-1775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	09/10/2024

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