Provider Demographics
NPI:1750635959
Name:HILDEBRAND, KRISTIN D (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:D
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:DARICE
Other - Last Name:KAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1640 N WELLS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1640 N WELLS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6087
Practice Address - Country:US
Practice Address - Phone:312-642-4300
Practice Address - Fax:312-642-4300
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009862225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics