Provider Demographics
NPI:1518639764
Name:KANTUREK, KATELYN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:KANTUREK
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 1:533 S DIVISION ST STE B
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3982
Mailing Address - Country:US
Mailing Address - Phone:331-215-4164
Mailing Address - Fax:331-904-7417
Practice Address - Street 1:533 S DIVISION ST STE B
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3982
Practice Address - Country:US
Practice Address - Phone:331-215-4164
Practice Address - Fax:331-904-7417
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0261532251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic