Provider Demographics
NPI:1831227750
Name:CHASE, KRISTINE M (PT)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:M
Last Name:CHASE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:7530 GLADSTONE DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1127
Mailing Address - Country:US
Mailing Address - Phone:401-263-1375
Mailing Address - Fax:
Practice Address - Street 1:1804 CENTRE POINT CIR STE 102
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4849
Practice Address - Country:US
Practice Address - Phone:630-955-1940
Practice Address - Fax:630-955-1944
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist