Provider Demographics
NPI:1225331408
Name:CARRIE CROZIER ARENA DPT
Entity Type:Organization
Organization Name:CARRIE CROZIER ARENA DPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.T.
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROZIER ARENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-968-6969
Mailing Address - Street 1:315 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2620
Mailing Address - Country:US
Mailing Address - Phone:630-968-6969
Mailing Address - Fax:
Practice Address - Street 1:315 W 63RD ST
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2620
Practice Address - Country:US
Practice Address - Phone:630-968-6969
Practice Address - Fax:630-968-8938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-017175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty