Kanak, Leslie

Kanak, Leslie is an individual health care provider with primary practice located at 211 E Hanover St , New Baden IL 62265-1811. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Kanak, Leslie can be contacted via phone (618) 234-9705.

Contact Information

Primary practice address
211 E Hanover St New Baden IL 62265-1811
Phone: (618) 234-9705
Fax: (618) 257-0665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070016337 Illinois

Profile Details

NPI number 1659699270
LBN Legal business name Kanak, Leslie
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2010
Last updated May 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659699270 NPPES
Illinois Other P00891171 RR MEDICARE PTAN

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