Provider Demographics
NPI:1053519157
Name:ARNOLDY, KATHRYN MARIE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:ARNOLDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 N WAYNE AVE
Mailing Address - Street 2:UNIT E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6055
Mailing Address - Country:US
Mailing Address - Phone:773-206-4516
Mailing Address - Fax:773-857-0570
Practice Address - Street 1:2750 N WAYNE AVE
Practice Address - Street 2:UNIT E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6055
Practice Address - Country:US
Practice Address - Phone:773-206-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-0129102251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics