Decant, Kristine Sue

Decant, Kristine Sue is an individual health care provider with primary practice located at 695 Park Ave , Lake Villa IL 60046-6531. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurology, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Decant, Kristine Sue can be contacted via phone (224) 541-9100.

Contact Information

Primary practice address
695 Park Ave Lake Villa IL 60046-6531
Phone: (224) 541-9100
Fax: (224) 541-9070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurology 2251N0400X 070017844 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurology 2251N0400X 12665 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070017844 Illinois

Profile Details

NPI number 1902973951
LBN Legal business name Decant, Kristine Sue
Credentials DPT, NCS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Mar 14th, 2023 - about 2 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 1902973951 NPPES
Illinois Other 59724004 MEDICARE PTAN
Illinois Other 070017844 MEDICARE PTAN

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