Provider Demographics
NPI:1245700178
Name:PORCO, KARRI ANN (DPT)
Entity type:Individual
Prefix:
First Name:KARRI
Middle Name:ANN
Last Name:PORCO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KARRI
Other - Middle Name:ANN
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
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:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:823 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1445
Practice Address - Country:US
Practice Address - Phone:269-248-4300
Practice Address - Fax:269-781-5505
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist