Provider Demographics
NPI:1174657605
Name:SCHWERMAN, KATHRYN RUTH (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RUTH
Last Name:SCHWERMAN
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21290 SYLVAN DR S
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9518
Mailing Address - Country:US
Mailing Address - Phone:847-909-9562
Mailing Address - Fax:224-778-6788
Practice Address - Street 1:21290 SYLVAN DR S
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-9518
Practice Address - Country:US
Practice Address - Phone:847-909-9562
Practice Address - Fax:224-778-6788
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILKK44980601P225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL222Q00000XOtherDEVELOPMENTAL THERAPIST