Provider Demographics
NPI:1831322684
Name:MCNAMARA, KATHLEEN ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:MCNAMARA
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 1:1345 RYAN PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-4530
Mailing Address - Country:US
Mailing Address - Phone:847-458-5072
Mailing Address - Fax:847-458-5070
Practice Address - Street 1:1345 RYAN PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-4530
Practice Address - Country:US
Practice Address - Phone:847-458-5072
Practice Address - Fax:847-458-5070
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.003094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist