Provider Demographics
NPI:1730479841
Name:SMITH, KAREN EDNALINO (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:EDNALINO
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 VININGS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:929 WEST HIGGINS ROAD,
Practice Address - Street 2:BARRINGTON ORTHOPEDIC SPECIALISTS, LTD.
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195
Practice Address - Country:US
Practice Address - Phone:847-885-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist