Provider Demographics
NPI:1134184872
Name:LAJOYE, KIMBERLY ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:LAJOYE
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 1:4460 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1899
Mailing Address - Country:US
Mailing Address - Phone:618-233-0277
Mailing Address - Fax:618-257-3291
Practice Address - Street 1:4460 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1899
Practice Address - Country:US
Practice Address - Phone:618-233-0277
Practice Address - Fax:618-257-3291
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
104259OtherGHP
5647306OtherFIRST HEALTH
714240OtherHEALTHLINK
5647306OtherFIRST HEALTH
ILK21138Medicare ID - Type UnspecifiedMEDICARE ILLINOIS