Katie Boudreau

Physical Therapy Assistant · Kankakee, IL

Individual Active NPI

NPI number 1801217153

Practice location

1601 Butterfield Trl
Kankakee, IL 60901-2959
Phone
(815) 936-6500

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NPI record

NPI
1801217153
Entity type
Individual (Type 1)
Enumeration date
January 3, 2014
Last updated
January 3, 2014
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 160.006489 IL

Mailing address

6170 W 2000n Rd
Bonfield, IL 60913-6700

About Katie Boudreau

Katie Boudreau is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1601 Butterfield Trl, Kankakee, IL 60901-2959. The NPI number 1801217153 was assigned on January 3, 2014 and the record was last updated on January 3, 2014.

Katie Boudreau lists a license in the registry: #160.006489 (IL) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Katie Boudreau?

The NPI number is 1801217153.

What is the phone number of Katie Boudreau?

The phone number listed for the practice location is (815) 936-6500.

Where is Katie Boudreau located?

1601 Butterfield Trl, Kankakee, IL 60901-2959.

What is the taxonomy code for Katie Boudreau?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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