Provider Demographics
NPI:1962838946
Name:BARBER, KENDALL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CORPORATE WOODS PKWY
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-3111
Mailing Address - Country:US
Mailing Address - Phone:847-634-9400
Mailing Address - Fax:847-634-2900
Practice Address - Street 1:50 S MILWAUKEE AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046
Practice Address - Country:US
Practice Address - Phone:847-634-9400
Practice Address - Fax:847-634-2900
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist