Provider Demographics
NPI:1730101692
Name:TREMAIN, LINDA KAY (PT ATC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:TREMAIN
Suffix:
Gender:F
Credentials:PT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6367 BANBURY
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516
Mailing Address - Country:US
Mailing Address - Phone:630-435-1800
Mailing Address - Fax:630-435-1888
Practice Address - Street 1:6301 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-2311
Practice Address - Country:US
Practice Address - Phone:630-321-9000
Practice Address - Fax:630-321-9006
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002221572OtherBCBS GROUP ID
ILK07732Medicare ID - Type Unspecified
K07732Medicare UPIN