Provider Demographics
NPI:1982679213
Name:KOUL, RITU R (RPT)
Entity Type:Individual
Prefix:MRS
First Name:RITU
Middle Name:R
Last Name:KOUL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 PRINCESS CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3186
Mailing Address - Country:US
Mailing Address - Phone:630-679-9119
Mailing Address - Fax:
Practice Address - Street 1:1012 95TH ST STE 10
Practice Address - Street 2:ABSOLUTE REHAB
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5041
Practice Address - Country:US
Practice Address - Phone:630-631-6253
Practice Address - Fax:630-679-9119
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK10855Medicare ID - Type Unspecified