Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kim Fonner

Individual provider Physical Therapy Assistant · NPI 1174748354

Kim Fonner is a Physical Therapy Assistant in Mattoon, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2007
Specialties on file
2

Practice location Address checks out

3395 W Lake Paradise Rd
Mattoon, IL 61938-8969
Phone: (217) 234-2327
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 056008777 (IL)
Physical Therapy Assistant Taxonomy 225200000X · Licence 160-002514 (IL)

Record details

NPI number1174748354
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 14, 2007
Last updated in NPPESAugust 28, 2017
Mailing address3395 W Lake Paradise Rd, Mattoon, IL 61938-8969

Other providers in Mattoon