Provider Demographics
NPI:1659509115
Name:KINETIX INCORPORATED
Entity Type:Organization
Organization Name:KINETIX INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:GICANA
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT, OCS
Authorized Official - Phone:312-351-4600
Mailing Address - Street 1:1419 W ARTHUR AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-5853
Mailing Address - Country:US
Mailing Address - Phone:312-351-4600
Mailing Address - Fax:312-284-8866
Practice Address - Street 1:1419 W ARTHUR AVE APT 3F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-5853
Practice Address - Country:US
Practice Address - Phone:312-351-4600
Practice Address - Fax:312-284-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.015911261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy