Basic Information
Provider Information
NPI: 1174980270
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: RACHEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LINS
OtherFirstName: RACHEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PT, DPT
OtherLastNameType: 1
Mailing Information
Address1: 790 REMINGTON BLVD
Address2:  
City: BOLINGBROOK
State: IL
PostalCode: 604404909
CountryCode: US
TelephoneNumber: 6302962223
FaxNumber: 6307599510
Practice Location
Address1: 100 VALLEY CENTER RD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198082950
CountryCode: US
TelephoneNumber: 3029941200
FaxNumber: 3029941233
Other Information
ProviderEnumerationDate: 01/20/2016
LastUpdateDate: 02/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XJ1-0003438DEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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