Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1459 | IL |
NPI | 1386739787 |
---|---|
Provider Name | Karen Lynn Popovic |
First Address | Palatine, IL 60074 |
Second Address | North Chicago, IL 60064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |