MEDICARE: KRISTINE CONWAY P.T.

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	070016788	IL

General Provider Information

NPI Number	:	1609173020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE CONWAY P.T.

Provider Business Mailing Address
First Line	:	55 S VAIL AVE APT 302
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1869
Country	:	US
Telephone Number	:	970-217-5971
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 S VAIL AVE APT 302
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1869
Country	:	US
Telephone Number	:	970-217-5971
Fax Number	:

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

Provider Enumeration Date	:	02/21/2011
Last Update Date	:	01/31/2023

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Directions to “ KRISTINE CONWAY P.T.” Practice Location

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