Provider Demographics
NPI:1811198666
Name:WINDY, KAREN SUE
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:WINDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-2101
Mailing Address - Country:US
Mailing Address - Phone:815-223-2037
Mailing Address - Fax:815-223-2037
Practice Address - Street 1:2029 11TH ST
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-2101
Practice Address - Country:US
Practice Address - Phone:815-223-2037
Practice Address - Fax:815-223-2037
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist