Kathleen Louise Buddell, P.T.
Individual provider Active NPI Physical Therapist · Bannockburn, IL
NPI 1780916759 · NPPES record last updated Feb 2, 2010
Key facts
- NPI
- 1780916759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070004996 (IL)
- Practice address
- 2525 Waukegan Rd
Suite 255
Bannockburn, IL 60015-5514 - Phone
- (847) 405-7611
- Fax
- (847) 405-7622
- NPI assigned
- Feb 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070004996 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070004996 | IL | Yes |
Addresses
Primary practice location
2525 Waukegan Rd
Suite 255
Bannockburn, IL 60015-5514
Mailing address
2525 Waukegan Rd
Suite 255
Bannockburn, IL 60015-5514
Phone (847) 405-7611
Other providers in Bannockburn, IL
- Jessica Bitzer
- Linda Bliwas
- Eve D Bloomgarden
- Bluestem Psychology PLLC
- Brent M Nathan MD PLLC
- David R Campbell
- Danielle Chams-Fern
- Wendy Chotiner
- Sara Chowdhury
- Clinical Connections
All providers in Bannockburn, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.