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

Individual provider Physical Therapist · NPI 1780453308

Konner Sloane Street, DPT is a Physical Therapist in Maryville, Illinois. Works from 2 locations. Licensed in Illinois and Kentucky.

Licensed in
IL, KY
In the registry since
2023
Specialties on file
3
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

6800 State Route 162
Maryville, IL 62062
Phone: (618) 288-5711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 71 Orphanage Rd, Ft Mitchell, KY 41017-3006 — (859) 331-0880

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070.029219 (IL)
Physical Therapist Taxonomy 225100000X · Licence 008995 (KY)
Pediatric Physical Therapist Taxonomy 2251P0200X · Licence 008995 (KY)

Record details

NPI number1780453308
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedDecember 22, 2023
Last updated in NPPESAugust 27, 2025
Certification dateAugust 27, 2025

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