Active NPI
Carey Dahlquist
- Physical Therapist
- Peoria, IL
National Provider Identifier
1215308192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070021581
- Practice address
- 2338 W Van Winkle Way
Suite 3100
Peoria, IL 61615-7483 - Phone
- (309) 693-9189
- NPI assigned
- Oct 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070021581 | IL | Primary |
Addresses
Primary practice location
2338 W Van Winkle Way
Suite 3100
Peoria, IL 61615-7483
Mailing address
2810 Frank Scott Pkwy W
Suite 824
Belleville, IL 62223-5007
Phone (618) 234-9705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070021581 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1215308192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 FRANK SCOTT PKWY W",
"address_2": "SUITE 824",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235007",
"telephone_number": "618-234-9705",
"fax_number": "618-257-0665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2338 W VAN WINKLE WAY",
"address_2": "SUITE 3100",
"city": "PEORIA",
"state": "IL",
"postal_code": "616157483",
"telephone_number": "309-693-9189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLQUIST",
"first_name": "CAREY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-16",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070021581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.