Provider Demographics
NPI:1659970614
Name:BURDETT, KATY JANE (DPT)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:JANE
Last Name:BURDETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:14190A BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5007
Practice Address - Country:US
Practice Address - Phone:240-542-5924
Practice Address - Fax:301-317-5629
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23755225100000X
MAPTL27184225100000X
WAPT61554044225100000X
PAPT028575225100000X
SC11229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist