Provider Demographics
NPI:1851405609
Name:BENDER, CATHLEEN ELLEN (PT)
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:ELLEN
Last Name:BENDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 E GRAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046
Mailing Address - Country:US
Mailing Address - Phone:847-356-4401
Mailing Address - Fax:847-356-4431
Practice Address - Street 1:1909 E. GRAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046
Practice Address - Country:US
Practice Address - Phone:847-356-4401
Practice Address - Fax:847-356-4431
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.004719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist