Provider Demographics
NPI:1689883670
Name:SCHATTE, KATIE JEAN (PTA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JEAN
Last Name:SCHATTE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JEAN
Other - Last Name:HUSBAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11943 HIGHWAY 4
Mailing Address - Street 2:
Mailing Address - City:AVA
Mailing Address - State:IL
Mailing Address - Zip Code:62907-2039
Mailing Address - Country:US
Mailing Address - Phone:618-426-3526
Mailing Address - Fax:
Practice Address - Street 1:900 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DU QUOIN
Practice Address - State:IL
Practice Address - Zip Code:62832-1230
Practice Address - Country:US
Practice Address - Phone:618-542-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant