Basic Information
| Provider Information | |||||||||
| NPI: | 1396291530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOLNER | ||||||||
| FirstName: | KARYN | ||||||||
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| NamePrefix: | MISS | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 TERRAMERE LN | ||||||||
| Address2: | |||||||||
| City: | LAKE IN THE HILLS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601565835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475292242 | ||||||||
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| Practice Location | |||||||||
| Address1: | 860 W WINCHESTER RD | ||||||||
| Address2: | #108 | ||||||||
| City: | LIBERTYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475739486 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2016 | ||||||||
| LastUpdateDate: | 08/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 070.022352 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.