Provider Demographics
NPI:1457875445
Name:HORAN, KATRINA A (DPT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:A
Last Name:HORAN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:A
Other - Last Name:SMEDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:3100 W MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4706
Practice Address - Country:US
Practice Address - Phone:804-342-5857
Practice Address - Fax:804-355-0408
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05954OtherGROUP MEDICARE PTAN