Provider Demographics
NPI:1790961530
Name:CANAR, PATRICIA ENRIQUEZ (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ENRIQUEZ
Last Name:CANAR
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:PO BOX 3497
Mailing Address - Street 2:
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-0300
Mailing Address - Country:US
Mailing Address - Phone:877-552-2996
Mailing Address - Fax:866-245-8064
Practice Address - Street 1:939 W MADISON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2638
Practice Address - Country:US
Practice Address - Phone:866-868-0764
Practice Address - Fax:312-492-7953
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist