Bettendorf, Carol
Bettendorf, Carol is an sole proprietor health care provider with primary practice located at 89 Cedar Ave , Lake Villa IL 60046-8411. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bettendorf, Carol can be contacted via phone (847) 265-7300.Contact Information
Primary practice address
89 Cedar Ave
Lake Villa IL 60046-8411
Phone: (847) 265-7300
Fax: (847) 265-7301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 070002049 | Illinois |
Profile Details
| NPI number | 1386784098 |
|---|---|
| LBN Legal business name | Bettendorf, Carol |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Sep 21st, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386784098 | NPPES |
| Illinois | Other | 04932271 | BLUE SHIELD |
| Illinois | Other | 710957905 | BLUE SHIELD |
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