Provider Demographics
NPI:1821168857
Name:CARLSEN, JAMES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CARLSEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W CENTRAL RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2402
Mailing Address - Country:US
Mailing Address - Phone:847-818-1235
Mailing Address - Fax:
Practice Address - Street 1:1100 W CENTRAL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2402
Practice Address - Country:US
Practice Address - Phone:847-818-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210820Medicare ID - Type UnspecifiedOUTPATIENT PHYSICAL THERA