Organization
DYNACARE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DINA M PETRICCA PT (PRESIDENT)
(847) 390-7666
Entity
Organization
Contact information
Practice address
1455 E GOLF RD, SUITE 110, DES PLAINES, IL 60016-1250
(847) 390-7666
(847) 390-9345
Mailing address
116 S HI LUSI AVE, MT PROSPECT, IL 60056-3025
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166=33438
BCBS
IL
Enumeration date
07/12/2005
Last updated
02/25/2008
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