Provider Demographics
NPI:1619363793
Name:FLORES, MAY KRISTINE SANTOS (PT)
Entity Type:Individual
Prefix:
First Name:MAY KRISTINE
Middle Name:SANTOS
Last Name:FLORES
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 1:28100 TORCH PKWY
Mailing Address - Street 2:#600
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3938
Mailing Address - Country:US
Mailing Address - Phone:630-413-5800
Mailing Address - Fax:
Practice Address - Street 1:28100 TORCH PKWY
Practice Address - Street 2:#600
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3938
Practice Address - Country:US
Practice Address - Phone:630-413-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist