Provider Demographics
NPI:1306935424
Name:HOYT, KERENSA D (PT)
Entity type:Individual
Prefix:
First Name:KERENSA
Middle Name:D
Last Name:HOYT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KERENSA
Other - Middle Name:L
Other - Last Name:DAVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:1012 95TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5041
Practice Address - Country:US
Practice Address - Phone:630-428-1503
Practice Address - Fax:630-428-1542
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070009681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK03981Medicare ID - Type UnspecifiedMEDICARE LOCALTIY 16
IL567700Medicare PIN
ILK03980Medicare ID - Type UnspecifiedMCARE LOCALITY 15
ILR03350Medicare PIN
ILR03349Medicare PIN
ILR03351Medicare PIN
IL568150Medicare PIN
ILP00285045Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IL568080Medicare PIN