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NPI Code Detail

MEDICARE: KRISTEN J. DALY MPT

MEDICARE: KRISTEN J. DALY MPT
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 TherapistIL

General Provider Information

NPI Number : 1831177005
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN J. DALY MPT
Provider Business Mailing Address
First Line : 3703 MUSTANG RD
Second Line :
City : JOLIET
State : IL
Zip : 60435-8811
Country : US
Telephone Number : 708-846-1042
Fax Number :
Provider Business Practice Location Address
First Line : 222 S RIVERSIDE PLZ
Second Line :
City : CHICAGO
State : IL
Zip : 60606-5808
Country : US
Telephone Number : 312-416-3804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 07/08/2007

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