Provider Demographics
NPI:1891036463
Name:KINLEN, KARINA (MSOTR/L)
Entity type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:
Last Name:KINLEN
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:MISS
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:KUZAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:PO BOX 416501 STE 140
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-3203
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:1502 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2327
Practice Address - Country:US
Practice Address - Phone:630-797-5658
Practice Address - Fax:630-797-5879
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008696225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0727500002Medicare NSC