Provider Demographics
NPI:1053857144
Name:CARE SOLUTIONS OF ILLINOIS INC
Entity Type:Organization
Organization Name:CARE SOLUTIONS OF ILLINOIS INC
Other - Org Name:DYNAMIC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-231-1404
Mailing Address - Street 1:612 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-1536
Mailing Address - Country:US
Mailing Address - Phone:309-231-1404
Mailing Address - Fax:309-291-0932
Practice Address - Street 1:612 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-1536
Practice Address - Country:US
Practice Address - Phone:309-231-1404
Practice Address - Fax:309-291-0932
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE SOLUTIONS OF ILLINOIS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010602261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy