Provider Demographics
NPI:1083088777
Name:KOHLMEIER, KRISTIN ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:ANN
Last Name:KOHLMEIER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E 2ND ST
Mailing Address - Street 2:PO BOX 133
Mailing Address - City:AROMA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60910-1005
Mailing Address - Country:US
Mailing Address - Phone:317-610-6990
Mailing Address - Fax:
Practice Address - Street 1:3703 W LAKE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1223
Practice Address - Country:US
Practice Address - Phone:847-998-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.021861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist