Provider Demographics
NPI:1225570922
Name:KUCHAN, MARGARET BRIDGET (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:BRIDGET
Last Name:KUCHAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9747 S LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2908
Mailing Address - Country:US
Mailing Address - Phone:708-860-9117
Mailing Address - Fax:
Practice Address - Street 1:1 TRANSAM PLAZA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4822
Practice Address - Country:US
Practice Address - Phone:630-627-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.005903225200000X
IL227.002405225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist