Provider Demographics
NPI:1497006019
Name:WE CARE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WE CARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUGENT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-828-1767
Mailing Address - Street 1:3801 N OAKLEY AVE
Mailing Address - Street 2:APT 2 WEST
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3813
Mailing Address - Country:US
Mailing Address - Phone:847-828-1767
Mailing Address - Fax:773-701-5858
Practice Address - Street 1:3801 N OAKLEY AVE
Practice Address - Street 2:APT 2 WEST
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3813
Practice Address - Country:US
Practice Address - Phone:847-828-1767
Practice Address - Fax:773-701-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070015267261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy