Provider Demographics
NPI:1306391255
Name:ALDERKS, CASSIE MCCALL (DPT)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:MCCALL
Last Name:ALDERKS
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 1:18770 E MCNEAL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE CENTER
Mailing Address - State:IL
Mailing Address - Zip Code:61052-9707
Mailing Address - Country:US
Mailing Address - Phone:815-218-3256
Mailing Address - Fax:
Practice Address - Street 1:2902 MCFARLAND RD
Practice Address - Street 2:SUITE #300
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6801
Practice Address - Country:US
Practice Address - Phone:815-316-6838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070022494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist