IndividualActive
Kyle Boudreau, P.T.
NPI 1336594282 · Physical Therapist · Bourbonnais, IL
Provider details
- NPI number
- 1336594282
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- P.T.
- Sex
- Male
- Sole proprietor
- No
- License
- 070020042 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
557 Main St Nw
Bourbonnais, IL 60914-2305
Phone: (815) 839-2090
Fax: (815) 209-9304
Street-level locationGet directions
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Additional practice locations (2)
- 1511 N Convent StBourbonnais, IL 60914Phone: (815) 401-5102Fax: (815) 401-5103
- 1397 Main St Ste aCrete, IL 60417-2951Phone: (708) 367-8050
Registry dates
- Enumerated
- 2016-04-28
- Last updated
- 2022-08-04
- Certified
- 2022-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.