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Carol Bettendorf, PT
Specialist in Lake Villa, Illinois
NPI 1386784098

Carol Bettendorf is a Specialist based in Lake Villa, IL. Carol Bettendorf practices in Lake Villa, IL and has the professional credentials of PT. The NPI Number for Carol Bettendorf is 1386784098 and holds a License No. 070002049 (Illinois).

The current practice location address for Carol Bettendorf is 89 Cedar Ave, Lake Villa, IL and can be reached out via phone at 847-265-7300 and via fax at 847-265-7301.

Location: 89 Cedar Ave, Lake Villa, IL, 60046-0764
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386784098
Provider Name
Carol Bettendorf
Credential
PT
Provider Entity Type
Individual
Gender
Female
Address
89 Cedar Ave, Lake Villa, IL, 60046-0764
Phone Number
847-265-7300
Fax Number
847-265-7301
Provider Enumeration Date
02/08/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
04932271 01 IL BLUE SHIELD
710957905 01 IL FEIN
institution
Provider Business Practice Location Address Details
Address
89 Cedar Ave
City
Lake Villa
State
Illinois
Zip
60046-8411
Phone Number
847-265-7300
Fax Number
847-265-7301
person
Provider Business Mailing Address Details
Address
89 Cedar Ave
City
Lake Villa
State
Illinois
Zip
60046-8411
Phone Number
847-265-7300
Fax Number
847-265-7301
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
070002049 (Illinois)
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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