Provider Demographics
NPI:1790924603
Name:BAYERS, KRISTINE (PT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:BAYERS
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 1:4223 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-2901
Mailing Address - Country:US
Mailing Address - Phone:773-661-2990
Mailing Address - Fax:773-661-2995
Practice Address - Street 1:4223 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-2901
Practice Address - Country:US
Practice Address - Phone:773-661-2990
Practice Address - Fax:773-661-2995
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008492225100000X
IL070017730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist