Provider Demographics
NPI:1720236870
Name:MASCIOLA, CAROLINE LINDSEY (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:LINDSEY
Last Name:MASCIOLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:CAROLINE
Other - Middle Name:LINDSEY
Other - Last Name:KRAWZAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:773-943-6341
Practice Address - Street 1:1675 DEMPSTER ST FL 3
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1110
Practice Address - Country:US
Practice Address - Phone:847-318-9330
Practice Address - Fax:847-723-9441
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0166252251P0200X
IL070016625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty