# DYNACARE PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598763864
- **Authorized official:** MRS. DINA M PETRICCA PT (PRESIDENT)
- **Authorized official phone:** (847) 390-7666

## Contact information

- **Practice address:** 1455 E GOLF RD, SUITE 110, DES PLAINES, IL 60016-1250
- **Practice address phone:** (847) 390-7666
- **Practice address fax:** (847) 390-9345
- **Mailing address:** 116 S HI LUSI AVE, MT PROSPECT, IL 60056-3025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | IL | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 02/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 166=33438 | BCBS | IL |