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General NPI Number Information
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NPI Number | 1770806226
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Entity Type | Individual
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Provider Name | CAROL ANN DIPRIMA P.T., C.W.S.
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 9977 WOODS DR NORTHSHORE PHYSICAL THERAPY DEPT
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City | SKOKIE
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State | IL
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Zip | 60077
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Country | US
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Telephone | 847-663-8126
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Fax | 847-663-8730
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Provider Business Mailing Address
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Address Line | 9023 MANGO AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-2543
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Country | US
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Telephone | 847-583-0817
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Fax | 847-583-0897
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070003520
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License Number State | IL
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