Provider Demographics
NPI:1336250455
Name:ROBINSON, KRISTINE JAROS (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:JAROS
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MR
Other - First Name:KRISTINE
Other - Middle Name:OLGA
Other - Last Name:JAROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-1940
Mailing Address - Fax:
Practice Address - Street 1:17045 TORRENCE AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-1014
Practice Address - Country:US
Practice Address - Phone:708-418-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist