Provider Demographics
NPI:1194369132
Name:TREASTER, KELSEY CAROLAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:CAROLAN
Last Name:TREASTER
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 1:1008 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5118
Mailing Address - Country:US
Mailing Address - Phone:847-863-2177
Mailing Address - Fax:
Practice Address - Street 1:7900 N MILWAUKEE AVE STE 7
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3172
Practice Address - Country:US
Practice Address - Phone:847-595-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist