Provider Demographics
NPI:1588749725
Name:COURTIN, TINA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:COURTIN
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 1:2721 STOCKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-6197
Mailing Address - Country:US
Mailing Address - Phone:630-333-6395
Mailing Address - Fax:
Practice Address - Street 1:2721 STOCKBERRY LN
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-6197
Practice Address - Country:US
Practice Address - Phone:630-333-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist