Provider Demographics
NPI:1407988736
Name:NOOTBAAR, PATRICIA LINDA (PTPCS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LINDA
Last Name:NOOTBAAR
Suffix:
Gender:F
Credentials:PTPCS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LINDA
Other - Last Name:MATRAS-NOOTBAAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTPCS
Mailing Address - Street 1:1572 BUNESCU LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1250
Mailing Address - Country:US
Mailing Address - Phone:847-913-9311
Mailing Address - Fax:847-913-9311
Practice Address - Street 1:1572 BUNESCU LN
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1250
Practice Address - Country:US
Practice Address - Phone:847-913-9311
Practice Address - Fax:847-913-9311
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist