CAROL BETTENDORF PT NPI 1386784098

NPI Information

NPI: 1386784098
Provider Name: CAROL BETTENDORF, PT
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
89 CEDAR AVE
LAKE VILLA, IL
ZIP 60046
Phone: (847) 265-7300
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Carol Bettendorf, PT is a specialist in Lake Villa, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Carol Bettendorf, PT NPI is 1386784098. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

89 CEDAR AVE
LAKE VILLA, IL
ZIP 60046-411
Phone: (847) 265-7300
Fax: (847) 265-7301

The enumeration date for this NPI number is 2/8/2007 and was last updated on 9/21/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		070002049	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	04932271	OTHER	ILLINOIS	BLUE SHIELD
2	710957905	OTHER	ILLINOIS	FEIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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