Organization
KIDNECTIVITY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENIFER BATES (BUSINESS DIRECTOR)
(847) 748-8733
Entity
Organization
Contact information
Practice address
600 WAUKEGAN RD STE 132, NORTHBROOK, IL 60062-1249
(847) 784-8733
Mailing address
310 N DEERE PARK DR W, HIGHLAND PARK, IL 60035-5374
(847) 748-8733
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070006291
IL
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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