Provider Demographics
NPI:1003413477
Name:SCHREINER, KIRSTEN NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:NICOLE
Last Name:SCHREINER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14411 TRINITY CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7007
Mailing Address - Country:US
Mailing Address - Phone:815-382-2180
Mailing Address - Fax:
Practice Address - Street 1:16 LILAC AVE
Practice Address - Street 2:
Practice Address - City:FOX LAKE
Practice Address - State:IL
Practice Address - Zip Code:60020-1803
Practice Address - Country:US
Practice Address - Phone:847-973-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15170-24225100000X
IL070.025307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist