Provider Demographics
NPI:1841803202
Name:MAHER, KATHRYN MARIE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:MAHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 S STATE ST # C403
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2692
Mailing Address - Country:US
Mailing Address - Phone:872-373-8294
Mailing Address - Fax:
Practice Address - Street 1:1155 S STATE ST # C403
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2692
Practice Address - Country:US
Practice Address - Phone:872-373-8294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.025409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist