Individual
BETTY CARRENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1505 W DEVON, CHICAGO, IL 60660
(773) 316-5305
(773) 743-4881
Mailing address
6039 N MOZART, CHICAGO, IL 60659
(773) 316-5305
(773) 743-4881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070010042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285635532
ORGANIZATION NPI
IL
01
—
300084121
TAX ID
IL
Enumeration date
12/14/2006
Last updated
08/12/2013
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