Doctor Name: | MARK S DECARLO |
NPI Number: | 1083811749 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 050018551 |
Business Practice Address: | 12505 Old Meridian St Suite 150 Carmel, IN - 460328723 |
Business Phone Number: | 3178199500 |
Business Fax Number: | 3178199501 |
Mailing Address: | 205 W Wacker Dr, Suite 1020 CHICAGO |
State: | IL |
Postal Code: | 606061216 |
Phone Number: | 3126400329 |
Fax Number: | 3126400407 |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 08/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 050018551 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |