Provider Demographics
NPI:1689123267
Name:KIDSTRONG PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:KIDSTRONG PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:FIGLIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:312-520-3759
Mailing Address - Street 1:310 HAPP RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3455
Mailing Address - Country:US
Mailing Address - Phone:312-520-3759
Mailing Address - Fax:
Practice Address - Street 1:310 HAPP RD
Practice Address - Street 2:SUITE 207
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3455
Practice Address - Country:US
Practice Address - Phone:312-520-3759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-24
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007845261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy