Individual
DARLENE MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
420 SUMMIT DR, LOCKPORT, IL 60441-3241
(815) 834-9901
(815) 834-9904
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070008761
IL
2251X0800X
Orthopedic Physical Therapist
070-008761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619980
BCBS OF IL
IL
Enumeration date
01/09/2006
Last updated
12/02/2008
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