Provider Demographics
NPI:1275738916
Name:ATKINS, CATHERINE MARIE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARIE
Last Name:ATKINS
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 1:1S701 MANCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1012
Mailing Address - Country:US
Mailing Address - Phone:630-393-3818
Mailing Address - Fax:
Practice Address - Street 1:831 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-8674
Practice Address - Country:US
Practice Address - Phone:630-681-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
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