Provider Demographics
NPI:1508878018
Name:KILBURG, KATHLEEN (MPT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:KILBURG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:337 W OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1419
Mailing Address - Country:US
Mailing Address - Phone:630-323-8646
Mailing Address - Fax:630-323-8656
Practice Address - Street 1:337 W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1419
Practice Address - Country:US
Practice Address - Phone:630-323-8646
Practice Address - Fax:630-323-8656
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-013503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist