Provider Demographics
NPI:1437770948
Name:CARLOS, CHERLYNE FERRER (ATC)
Entity Type:Individual
Prefix:MS
First Name:CHERLYNE
Middle Name:FERRER
Last Name:CARLOS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4821
Mailing Address - Country:US
Mailing Address - Phone:630-800-8891
Mailing Address - Fax:
Practice Address - Street 1:7500 W MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-1196
Practice Address - Country:US
Practice Address - Phone:708-456-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0029012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer