Provider Demographics
NPI:1629390976
Name:LORCH, KAREN (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LORCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:POTTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2920 W. 183RD STREET
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2868
Mailing Address - Country:US
Mailing Address - Phone:708-957-0095
Mailing Address - Fax:708-957-0096
Practice Address - Street 1:2920 W. 183RD STREET
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2868
Practice Address - Country:US
Practice Address - Phone:708-957-0095
Practice Address - Fax:708-957-0096
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070005598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist