Provider Demographics
NPI:1760590533
Name:HAUGE, KATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HAUGE
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 1:5005 NEWPORT DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3832
Mailing Address - Country:US
Mailing Address - Phone:847-797-1050
Mailing Address - Fax:847-797-1337
Practice Address - Street 1:975 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3356
Practice Address - Country:US
Practice Address - Phone:847-797-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist