Provider Demographics
NPI:1093977043
Name:LIND, KIMBERLY JOY (PT)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:JOY
Last Name:LIND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4910
Mailing Address - Country:US
Mailing Address - Phone:888-553-6569
Mailing Address - Fax:833-291-6616
Practice Address - Street 1:141 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-4910
Practice Address - Country:US
Practice Address - Phone:847-752-4554
Practice Address - Fax:847-485-5954
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070011655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist