Provider Demographics
NPI:1659320315
Name:OSER, CAROLE ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ANN
Last Name:OSER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:ANN
Other - Last Name:HOLZHAUSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 CENTRAL AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2666
Mailing Address - Country:US
Mailing Address - Phone:847-512-4070
Mailing Address - Fax:847-512-4345
Practice Address - Street 1:1100 CENTRAL AVE
Practice Address - Street 2:SUITE G
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2666
Practice Address - Country:US
Practice Address - Phone:847-512-4070
Practice Address - Fax:847-512-4345
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070003077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01639010OtherBC/BS PROVIDER NUMBER
IL01639010OtherBC/BS PROVIDER NUMBER