Provider Demographics
NPI:1457581670
Name:WILLIAMS, KRISTIN L
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:L
Other - Last Name:KELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2165 S TONNE DR
Mailing Address - Street 2:221
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4166
Mailing Address - Country:US
Mailing Address - Phone:630-605-6713
Mailing Address - Fax:
Practice Address - Street 1:2165 S TONNE DR
Practice Address - Street 2:221
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4166
Practice Address - Country:US
Practice Address - Phone:630-605-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist