David Carroll
Individual provider Active NPI Physical Therapist · Flossmoor, IL
NPI 1487024352 · NPPES record last updated Oct 4, 2015
Key facts
- NPI
- 1487024352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070004045 (IL)
- Practice address
- 2113 Hagen LN
Flossmoor, IL 60422-1617 - Phone
- (708) 957-2531
- NPI assigned
- Oct 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070004045 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070004045 | IL | Yes |
Addresses
Primary practice location
2113 Hagen LN
Flossmoor, IL 60422-1617
Mailing address
2113 Hagen LN
Flossmoor, IL 60422-1617
Phone (708) 957-2531
Other providers in Flossmoor, IL
- Raegan Campbell
- Caplea Family Medicine
- Andrea Lindley Caplea
- Geoffrey O Caplea
- Caring Hands Wellness, LLC
- Gwyneeda Carter-Sidberry
- Yolanda Cartwright
- Candice L Chambers
- Charisma Therapy Associates P LLC
- Lauren Chasey
All providers in Flossmoor, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.