Provider Demographics
NPI:1386713006
Name:FOWLES, CORTNEY (PT)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:FOWLES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CORTNEY
Other - Middle Name:
Other - Last Name:SCHMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:530 ROCKLAND RD
Mailing Address - Street 2:STE 500
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4137
Mailing Address - Country:US
Mailing Address - Phone:847-381-0090
Mailing Address - Fax:847-381-0181
Practice Address - Street 1:530 N HOUGH ST
Practice Address - Street 2:SUITE 130
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3087
Practice Address - Country:US
Practice Address - Phone:847-381-0090
Practice Address - Fax:847-381-0181
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-016726225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22736OtherLICENSE#