Provider Demographics
NPI:1427140946
Name:BYERS, KATHRYN K (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:K
Last Name:BYERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:630-296-2223
Mailing Address - Fax:
Practice Address - Street 1:201 EAST ROUTE 6
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-8210
Practice Address - Country:US
Practice Address - Phone:815-416-0046
Practice Address - Fax:815-416-0150
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK53187Medicare PIN
ILK26472Medicare PIN
ILK53189Medicare PIN
ILIL3585004Medicare PIN
ILP00330718Medicare PIN
ILK53188Medicare PIN