Provider Demographics
NPI:1639482938
Name:DEJESUS, CARLOS ADOLFO (DPT)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ADOLFO
Last Name:DEJESUS
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7443 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2909
Practice Address - Country:US
Practice Address - Phone:219-844-8100
Practice Address - Fax:219-844-7460
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X
IN05010376A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist