Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 070.014940 | IL |
Y | 2251P0200X | Physical Therapist - Pediatrics | 070.014940 | IL |
NPI | 1649458175 |
---|---|
Provider Name | Mrs. Kristin Ann Maresca |
First Address | Plainfield, IL 60544-2439 |
Second Address | Plainfield, IL 60544-2439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2008 |
Last Update Date | 25/01/2016 |