Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIM FONNER
Active Sole ProprietorKIM FONNER is a Pediatric Occupational Therapist healthcare provider located in MATTOON, Illinois. NPI 1174748354 is currently active in the NPPES registry. Verify at CMS.
Pediatric Occupational Therapist · MATTOON, IL
Registration Details
- NPI Number
- 1174748354
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 14, 2007 (19.374061463583 yrs)
- Last Updated
- Aug 28, 2017
- Licenses
-
160-002514 (IL)056008777 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3395 W LAKE PARADISE RDMATTOON, IL, 619388969Browse IL providers · Browse ZIP 61938
- Phone
- 2172342327
- Primary Specialty
-
Pediatric Occupational Therapist
225XP0200X
- Additional Specialty
- Pediatric Occupational Therapist
Other Pediatric Occupational Therapist Providers in MATTOON, IL
| Name | Credential | NPI |
|---|---|---|
| KAREN SMITH | OT | 1326477803 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.