Provider Demographics
NPI:1831998186
Name:LARSON, CAELEY FRANCES (DPT)
Entity type:Individual
Prefix:
First Name:CAELEY
Middle Name:FRANCES
Last Name:LARSON
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 1:11600 N SCOTT SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:IL
Mailing Address - Zip Code:60541-9643
Mailing Address - Country:US
Mailing Address - Phone:815-414-0780
Mailing Address - Fax:
Practice Address - Street 1:2500 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:IL
Practice Address - Zip Code:61764-9784
Practice Address - Country:US
Practice Address - Phone:815-842-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070028947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist