Provider Demographics
NPI:1689021446
Name:WOOD, KATHERINE MR (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MR
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:REINERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-8582
Mailing Address - Country:US
Mailing Address - Phone:630-940-6937
Mailing Address - Fax:
Practice Address - Street 1:1115 SPINNAKER ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-8582
Practice Address - Country:US
Practice Address - Phone:630-940-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist