=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356207716
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DINA FLORES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2025
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 573 W IL ROUTE 22
-----------------------------------------------------
City | LAKE ZURICH
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60047-2550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-796-3320
-----------------------------------------------------
Fax | 847-796-3342
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 BUTTERFIELD RD STE 1600
-----------------------------------------------------
City | DOWNERS GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60515-1211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-796-3320
-----------------------------------------------------
Fax | 847-796-3342
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 070029664
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------