Provider Demographics
NPI:1316175482
Name:CARR, LINDSAY E (PT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:E
Last Name:CARR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:E
Other - Last Name:MEDENDORP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-2000
Mailing Address - Fax:
Practice Address - Street 1:430 WARRENVILLE RD STE 310
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1348
Practice Address - Country:US
Practice Address - Phone:630-967-2000
Practice Address - Fax:630-432-6191
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-017345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00802723OtherMEDICARE RR
ILP00846701OtherMEDICARE RAILROAD
IL216859024Medicare PIN
ILP00802723OtherMEDICARE RR
IL206974004Medicare PIN
IL209812002Medicare PIN