Doctor Name: | KELLIE AUDRA BANFIELD |
NPI Number: | 1093059743 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | |
Business Practice Address: | 805 Davis St Evanston, IL - 602014401 |
Business Phone Number: | 8478641535 |
Business Fax Number: | 8478641537 |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | 6302962222 |
Fax Number: | 6307599510 |
NPI Enumeration Date: | 11/19/2012 |
NPI Last Update Date: | 04/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |