Provider Demographics
NPI:1235189341
Name:CAHALAN, PATRICIA R/ (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:R/
Last Name:CAHALAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1156
Mailing Address - Country:US
Mailing Address - Phone:847-432-4867
Mailing Address - Fax:847-432-4868
Practice Address - Street 1:3066 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-1156
Practice Address - Country:US
Practice Address - Phone:847-432-4867
Practice Address - Fax:847-432-4868
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-010222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist