Provider Demographics
NPI:1235776048
Name:CARTER, TONEE
Entity Type:Individual
Prefix:
First Name:TONEE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONEE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3863 BLUE HERON CIR
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3253
Mailing Address - Country:US
Mailing Address - Phone:161-473-5501
Mailing Address - Fax:
Practice Address - Street 1:1760 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-4791
Practice Address - Country:US
Practice Address - Phone:847-221-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-30
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106S00000X
ILRBT-19-107412106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician