Charlene Joy Fallows

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

100000886 Issued in IL

Practice address

3300 Milwaukee Ave
Northbrook, IL 60062-7126

Phone

(847) 795-9700

NPI assigned

Jun 19, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1194400143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 SUTTON DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623017",
            "telephone_number": "847-338-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627126",
            "telephone_number": "847-795-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLOWS",
        "first_name": "CHARLENE",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "100000886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• F.C Hooseki LLC
• Stephanie Fabiyi
• Molly Fagan
• Kristen Faisant, LCPC
• Megan Fallon
• Thomas Fallows
• Families Building Dreams
• Family Doctors of Northbrook
• Family Physicians of the North Shore, LLC
• Rachel Fancher, PSY.D.

• Physical Therapy Assistant in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.