Provider Demographics
NPI:1700213709
Name:KAMINSKI, CHRIS (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:KAMINSKI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 N LAKE SHORE DR
Mailing Address - Street 2:UNIT# 2815
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6232
Mailing Address - Country:US
Mailing Address - Phone:847-404-4407
Mailing Address - Fax:
Practice Address - Street 1:2222 W DIVISION ST STE 320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3096
Practice Address - Country:US
Practice Address - Phone:773-227-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist