Provider Demographics
NPI:1801014790
Name:KRUSE, CATHERINE J (MS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:J
Last Name:KRUSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 N DELAPLAINE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-2070
Mailing Address - Country:US
Mailing Address - Phone:708-442-7515
Mailing Address - Fax:708-442-7515
Practice Address - Street 1:148 N DELAPLAINE RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-2070
Practice Address - Country:US
Practice Address - Phone:708-442-7515
Practice Address - Fax:708-442-7515
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist