Provider Demographics
NPI:1134523491
Name:KECSKES, BETHANY ANNE JUTZY
Entity type:Individual
Prefix:
First Name:BETHANY ANNE
Middle Name:JUTZY
Last Name:KECSKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:ANNE
Other - Last Name:JUTZY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:570-550-0168
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:1564 ROUTE 507 STE C
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18426-4502
Practice Address - Country:US
Practice Address - Phone:570-676-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031012225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist