Provider Demographics
NPI:1912105263
Name:DEFANO, KARI ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:ANN
Last Name:DEFANO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16323 LEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-4004
Mailing Address - Country:US
Mailing Address - Phone:630-205-2226
Mailing Address - Fax:815-436-7525
Practice Address - Street 1:16323 LEWOOD DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-4004
Practice Address - Country:US
Practice Address - Phone:630-205-2226
Practice Address - Fax:815-436-7525
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics