MEDICARE: KRISTEN KAY JUNKER 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	070.024593	IL

General Provider Information

NPI Number	:	1235769647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN KAY JUNKER DPT

Provider Business Mailing Address
First Line	:	31 LAKEVIEW DR
Second Line	:
City	:	FREEBURG
State	:	IL
Zip	:	62243-1808
Country	:	US
Telephone Number	:	618-606-3251
Fax Number	:

Provider Business Practice Location Address
First Line	:	2724 SOUTHFIELD DR
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62301-6530
Country	:	US
Telephone Number	:	618-606-3251
Fax Number	:

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

Provider Enumeration Date	:	01/24/2020
Last Update Date	:	04/17/2025

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