Provider Demographics
NPI:1104170299
Name:SCHUCK, CARA ANNE (ATC)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:ANNE
Last Name:SCHUCK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 HASSELL RD APT 105
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2105
Mailing Address - Country:US
Mailing Address - Phone:630-487-7861
Mailing Address - Fax:
Practice Address - Street 1:5157 MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4616
Practice Address - Country:US
Practice Address - Phone:630-435-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.003367111NR0400X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No111NR0400XChiropractic ProvidersChiropractorRehabilitation