Provider Demographics
NPI:1184954018
Name:CAROD, IRENE
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:CAROD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAINSAIL DR
Mailing Address - Street 2:
Mailing Address - City:THIRD LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2605
Mailing Address - Country:US
Mailing Address - Phone:630-418-5444
Mailing Address - Fax:
Practice Address - Street 1:121 MAINSAIL DR
Practice Address - Street 2:
Practice Address - City:THIRD LAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2605
Practice Address - Country:US
Practice Address - Phone:630-418-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2025-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist