Provider Demographics
NPI:1093529950
Name:CLAIRE, KENDALL (DPT)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:CLAIRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 KINGTREE DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-5602
Mailing Address - Country:US
Mailing Address - Phone:815-685-6572
Mailing Address - Fax:
Practice Address - Street 1:1221 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-2508
Practice Address - Country:US
Practice Address - Phone:815-416-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070028198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist