Provider Demographics
NPI:1477522878
Name:DOWELL, KAREN MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:DOWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6149 NIMTZ RD
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111
Mailing Address - Country:US
Mailing Address - Phone:815-885-2626
Mailing Address - Fax:
Practice Address - Street 1:3920 N MULFORD RD
Practice Address - Street 2:#2200
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114
Practice Address - Country:US
Practice Address - Phone:815-639-0764
Practice Address - Fax:815-639-0946
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist