Provider Demographics
NPI:1023188380
Name:CARTON, MARGARET ELLEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELLEN
Last Name:CARTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:ELLEN
Other - Last Name:DOAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2202 30TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5003
Mailing Address - Country:US
Mailing Address - Phone:309-786-9647
Mailing Address - Fax:309-797-8072
Practice Address - Street 1:1050 36TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7126
Practice Address - Country:US
Practice Address - Phone:309-797-8778
Practice Address - Fax:309-797-8072
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08130333OtherBLUE CROSS BLUE SHIELD
IL08130333OtherBLUE CROSS BLUE SHIELD