Basic Information
| Provider Information | |||||||||
| NPI: | 1861778516 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KILIAN | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MOTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E FRANKLIN ST | ||||||||
| Address2: | UNIT 203 | ||||||||
| City: | ELDRIDGE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527481336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5639401810 | ||||||||
| FaxNumber: | 8552328604 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 E FRANKLIN ST | ||||||||
| Address2: | UNIT 203 | ||||||||
| City: | ELDRIDGE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527481336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5639401810 | ||||||||
| FaxNumber: | 8552328604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2011 | ||||||||
| LastUpdateDate: | 02/27/2019 | ||||||||
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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 | 225X00000X | 002139 | IA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 056009662 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.