Carrie R. Cook, PT

Individual provider Active NPI Geriatric Physical Therapist · Golden, IL

NPI 1457546277 · NPPES record last updated Sep 15, 2007

Key facts

NPI
1457546277
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Physical Therapist 2251G0304X
License
070004200 (IL)
Practice address
101 Prairie Mills Rd
Golden, IL 62339-1016
Phone
(217) 696-4421
Fax
(217) 696-4393
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070004200ILMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Caremark Rehab, LTD. Geriatrics Past
since Sep 10, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 070004200 IL Yes

Addresses

Primary practice location

101 Prairie Mills Rd
Golden, IL 62339-1016

Mailing address

2834 N 2200TH Ave
Clayton, IL 62324-2312
Phone (217) 696-4881

Other providers in Golden, IL

All providers in Golden, IL · Geriatric Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.