Provider Demographics
NPI:1013972942
Name:MACAS, DENNIS T (ATC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:T
Last Name:MACAS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 73RD PLACE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-3773
Mailing Address - Country:US
Mailing Address - Phone:630-960-2271
Mailing Address - Fax:
Practice Address - Street 1:9800 LAWLER AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1215
Practice Address - Country:US
Practice Address - Phone:847-626-2292
Practice Address - Fax:847-626-3300
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer