Dianne Zuasula Catolos, PT, DPT
Individual provider Active NPI Physical Therapist · Carbondale, IL
NPI 1629686019 · NPPES record last updated Jul 21, 2020
Key facts
- NPI
- 1629686019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070021853 (IL)
- Practice address
- 405 W Jackson St
Carbondale, IL 62901-1462 - Phone
- (618) 751-3817
- NPI assigned
- Jul 21, 2020
- Sex
- Female
- 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 |
|---|---|---|---|
| 070021853 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 070021853 | IL | Yes |
Addresses
Primary practice location
405 W Jackson St
Carbondale, IL 62901-1462
Mailing address
211 Wildrose LN Apt B
Marion, IL 62959-1216
Phone (618) 751-3817
Other providers in Carbondale, IL
- Nathan Dean Caslow
- Lindsay B Casolari
- Thomas Roger Casper
- Ken Castillo
- Catholic Social Services Carbondale
- Mary Kay Cattaneo
- Meagan Elizabeth Causey
- Melissa Cauthen
- Cedar Court Imaging LTD
- Center for Autism Spectrum Disorders
All providers in Carbondale, 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 Jul 21, 2020. 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.