Provider Demographics
NPI:1477700268
Name:PERRONE, KRYSTAL LYNN (DPT)
Entity type:Individual
Prefix:MISS
First Name:KRYSTAL
Middle Name:LYNN
Last Name:PERRONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:KRYSTAL
Other - Middle Name:LYNN
Other - Last Name:MULLER
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:803-812-3656
Mailing Address - Fax:
Practice Address - Street 1:37464 LION DR
Practice Address - Street 2:STE 4
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-3879
Practice Address - Country:US
Practice Address - Phone:302-988-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24932225100000X, 225100000X
DEJ1-0002307225100000X
DEJ1-0004217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist