Provider Demographics
NPI:1952352940
Name:THOPE, KISHORILAL L (PT)
Entity Type:Individual
Prefix:MR
First Name:KISHORILAL
Middle Name:L
Last Name:THOPE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 TREFOIL
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-8511
Mailing Address - Country:US
Mailing Address - Phone:217-343-9023
Mailing Address - Fax:217-355-1897
Practice Address - Street 1:501 TREFOIL
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-8511
Practice Address - Country:US
Practice Address - Phone:217-343-9023
Practice Address - Fax:217-355-1897
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist