Provider Demographics
NPI:1356565238
Name:CREATIVE THERAPEUTICS, LTD.
Entity type:Organization
Organization Name:CREATIVE THERAPEUTICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:BATALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:815-758-5508
Mailing Address - Street 1:400 E HILLCREST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2470
Mailing Address - Country:US
Mailing Address - Phone:815-758-5508
Mailing Address - Fax:815-758-5537
Practice Address - Street 1:400 E HILLCREST DR STE 110
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2470
Practice Address - Country:US
Practice Address - Phone:815-758-5508
Practice Address - Fax:815-758-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-013157225100000X
IL070-013129225100000X
IL160-000589225200000X
IL227-001277225700000X
IL056-005205225X00000X
IL070-005903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1921441OtherBLUE CROSS BLUE SHIELD
IL1921441OtherBLUE CROSS BLUE SHIELD