Basic Information
Provider Information
NPI: 1003152406
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPPS
FirstName: LINDSEY
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 790 REMINGTON BLVD
Address2:  
City: BOLINGBROOK
State: IL
PostalCode: 604404909
CountryCode: US
TelephoneNumber: 6302962223
FaxNumber:  
Practice Location
Address1: 586 LONE TREE DR
Address2:  
City: MT PLEASANT
State: SC
PostalCode: 294648170
CountryCode: US
TelephoneNumber: 8438847880
FaxNumber: 8438846635
Other Information
ProviderEnumerationDate: 12/13/2012
LastUpdateDate: 05/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH6808ALN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X08296LAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X8135SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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