Individual
CONSTANCE TARAS KARWANDYAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
211 N STETSON AVE, CHICAGO, IL 60601-7803
(312) 801-8440
Mailing address
211 N STETSON AVE, CHICAGO, IL 60601-7803
(312) 801-8440
(128) 018-4413
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070023441
IL
225100000X
Physical Therapist
10103
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6021023
BCBS TN
TN
05
—
Q008736
—
TN
Enumeration date
09/02/2014
Last updated
12/17/2019
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