Provider Demographics
NPI:1821346958
Name:TAYLOR, KRISTYN (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N WESTMORELAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1601
Mailing Address - Country:US
Mailing Address - Phone:847-735-8500
Mailing Address - Fax:847-535-8488
Practice Address - Street 1:1200 N WESTMORELAND RD STE 100
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1601
Practice Address - Country:US
Practice Address - Phone:847-735-8500
Practice Address - Fax:847-535-8488
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist