MEDICARE: KATHRYN CUTRERA D.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	42219	CA

General Provider Information

NPI Number	:	1609267509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CUTRERA D.P.T.

Provider Business Mailing Address
First Line	:	2217 N CLIFTON AVE APT 1E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3528
Country	:	US
Telephone Number	:	812-327-9712
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 N CLIFTON AVE APT 1E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3528
Country	:	US
Telephone Number	:	812-327-9712
Fax Number	:

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

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	01/03/2022

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