Provider Demographics
NPI:1962699579
Name:KOTARINOS, RHONDA KAY (DPT)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:KAY
Last Name:KOTARINOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TRANSAM PLAZA DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 TRANSAM PLAZA DR
Practice Address - Street 2:SUITE 170
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4822
Practice Address - Country:US
Practice Address - Phone:630-620-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-1883174400000X
FLPT6646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014125600Medicaid
FLY0P19OtherBLUE CROSS BLUE SHIELD
FLIA928YMedicare PIN