Provider Demographics
NPI:1114174364
Name:PAULSEN, LINDSAY CLARE (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CLARE
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E ONTARIO ST
Mailing Address - Street 2:STE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3223
Mailing Address - Country:US
Mailing Address - Phone:312-225-3119
Mailing Address - Fax:
Practice Address - Street 1:227 E ONTARIO ST
Practice Address - Street 2:STE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3223
Practice Address - Country:US
Practice Address - Phone:312-225-3119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.016582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215681001Medicare Oscar/Certification