Provider Demographics
NPI:1184825812
Name:NORKUTE, INGRIDA (PTA)
Entity Type:Individual
Prefix:
First Name:INGRIDA
Middle Name:
Last Name:NORKUTE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:INGRIDA
Other - Middle Name:
Other - Last Name:COPIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:3214 S UNION ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:708-268-2925
Mailing Address - Fax:
Practice Address - Street 1:1111 SUPERIOR
Practice Address - Street 2:WESTLAKE HOSPITAL
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160
Practice Address - Country:US
Practice Address - Phone:708-268-2925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant