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NPI Code Detail

MEDICARE: KRISTINA NIELSEN BIRCH DPT

MEDICARE: KRISTINA NIELSEN BIRCH 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
1225100000XPhysical Therapist070014354IL

General Provider Information

NPI Number : 1235147851
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA NIELSEN BIRCH DPT
Provider Business Mailing Address
First Line : 20781 N MEADOW LN
Second Line :
City : DEER PARK
State : IL
Zip : 60010-3627
Country : US
Telephone Number : 737-472-2731
Fax Number :
Provider Business Practice Location Address
First Line : 2533 N SOUTHPORT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7166
Country : US
Telephone Number : 773-472-2731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 11/22/2023

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Directions to “ KRISTINA NIELSEN BIRCH DPT” Practice Location

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