Organization
KIDNETICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LYONS PT (PRESIDENT)
(312) 320-2823
Entity
Organization
Contact information
Practice address
1130 N FRANCISCO AVE, CHICAGO, IL 60622-2712
(312) 320-2823
(773) 862-0003
Mailing address
1130 N FRANCISCO AVE, CHICAGO, IL 60622-2712
(312) 320-2823
(773) 862-0003
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630323
BCBS PROVIDER NUMBER
IL
Enumeration date
11/13/2006
Last updated
08/22/2020
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