Provider Demographics
NPI:1295792695
Name:CACHARES, GEORGE W (PT,MS)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:CACHARES
Suffix:
Gender:M
Credentials:PT,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3614
Mailing Address - Country:US
Mailing Address - Phone:708-906-7564
Mailing Address - Fax:708-499-4597
Practice Address - Street 1:9735 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3614
Practice Address - Country:US
Practice Address - Phone:708-906-7564
Practice Address - Fax:708-499-4597
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-003671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist