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Individual
DR. KRISTINE SUE DECANT
Active
Individual
DR. KRISTINE SUE DECANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, NCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017844
IL
2251N0400X
Neurology Physical Therapist
070017844
IL
2251N0400X
Neurology Physical Therapist
12665
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070017844
IL-LICENSE
IL
01
—
59724004
MEDICARE PTAN
IL
Enumeration date
11/28/2006
Last updated
03/14/2023
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