Provider Demographics
NPI:1396254140
Name:THE CARPAL TUNNEL CENTER LLC
Entity type:Organization
Organization Name:THE CARPAL TUNNEL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-239-9670
Mailing Address - Street 1:1605 S STATE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7231
Mailing Address - Country:US
Mailing Address - Phone:217-239-9670
Mailing Address - Fax:217-480-3031
Practice Address - Street 1:1605 S STATE ST STE 1A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7231
Practice Address - Country:US
Practice Address - Phone:217-239-9670
Practice Address - Fax:217-480-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty