Wagner, Kristin

Wagner, Kristin is an individual health care provider with primary practice located at 806 Laraway Rd 808, New Lenox IL 60451-2694. 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. Wagner, Kristin can be contacted via phone (815) 462-8416.

Contact Information

Primary practice address
806 Laraway Rd 808 New Lenox IL 60451-2694
Phone: (815) 462-8416
Fax: (815) 462-8425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070011465 Illinois

Profile Details

NPI number 1265629307
LBN Legal business name Wagner, Kristin
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2007
Last updated Jun 18th, 2024 - about 3 months 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 1265629307 NPPES
Illinois Other P00931608 MEDICARE RAILROAD

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