Provider Demographics
NPI:1194076679
Name:KENDER, ANNE ELISE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELISE
Last Name:KENDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:ELISE
Other - Last Name:BODNAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:12787 S SAGINAW ST
Practice Address - Street 2:SUITE C4
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1830
Practice Address - Country:US
Practice Address - Phone:810-771-7631
Practice Address - Fax:810-771-7976
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist