Provider Demographics
NPI:1154445104
Name:KRIEMELMEYER, KATHARINE JOYCE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:JOYCE
Last Name:KRIEMELMEYER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KATHARINE
Other - Middle Name:JOYCE
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:527 HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-7323
Mailing Address - Country:US
Mailing Address - Phone:630-682-8226
Mailing Address - Fax:
Practice Address - Street 1:527 HAMILTON DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-7323
Practice Address - Country:US
Practice Address - Phone:630-682-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist