Carol Bettendorf in Lake Villa - Specialist
Carol Bettendorf - NPI 1386784098
Carol Bettendorf is a Specialist in Lake Villa, Illinois. Carol Bettendorf practices all healthcare services and medical treatments related to Specialist. The NPI Number for Carol Bettendorf is 1386784098. The last update date is 2010-09-21.
Carol Bettendorf's current location address is Po Box 764, Lake Villa, Illinois. You can contact this provider via phone number 8472657300 and fax number 8472657301. The mailing address for Carol Bettendorf is Po Box 764, Lake Villa, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carol Bettendorf |
|---|---|
| Address | Po Box 764, Lake Villa, Illinois |
| Phone Number | 8472657300 |
| Fax Number | 8472657301 |
| Sole Proprietor | Y |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1386784098 |
|---|---|
| Provider Enumeration Date | 2007-02-08 |
| Last Updated Date | 2010-09-21 |
Provider Mailing Address Detail
| Address | Po Box 764 |
|---|---|
| City | Lake Villa |
| State | Illinois (IL) |
| Post Code | 600460764 |
| Phone Number | 8472657300 |
| Fax Number | 8472657301 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 70002049 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4932271 | IL | BLUE SHIELD | |
| 710957905 | IL | FEIN |
Post Comment/ Review Below
What is the Carol Bettendorf's unique identification number?
The Carol Bettendorf has been assigned the NPI (National Provider Identifier) Number 1386784098 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Carol Bettendorf is geographically located?
The Carol Bettendorf is physically situated at the following location: Po Box 764, Lake Villa, IL, 600460764.
What is Carol Bettendorf's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Carol Bettendorf is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did the Carol Bettendorf receive its 1386784098 assignment from the Centers for Medicare & Medicaid Services?
The Carol Bettendorf was assigned its 1386784098 by the Centers for Medicare & Medicaid Services on 2007-02-08.
As of what date was the information regarding Carol Bettendorf, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Carol Bettendorf, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2010-09-21.