Candice Caruso, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096003545 Issued in IL

Practice address

2400 Home Ave
Berwyn, IL 60402-2110

Phone

(708) 780-4100

NPI assigned

Mar 25, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: candice.caruso@athletico.com

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1407506256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 CLARENCE AVE # 1S",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604025045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOME AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022110",
            "telephone_number": "708-780-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "CANDICE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096003545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Candice.caruso@athletico.com",
            "affiliation": "Y",
            "endpointDescription": "Professional email",
            "affiliationName": "ATHLETICO LTD",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "542 N Rand Rd",
            "city": "Lake Zurich",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600473103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Ellen Cardona, PTA
• Care Pediatrics LLC
• Robin Lynn Carlson, P.T.
• Yanitza Cassandra Carmona Y Correa, MSW
• Yaritsa Carrasco, MS
• Carlos Castaneda, MD
• Jorge Luis Castelar Artiga
• Ana Karen Castellanos
• Coralia Gissel Castillo, MD
• Maria G Castillo, MSW

• Athletic Trainer in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.