Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 070.013454 | IL |
Y | 2251P0200X | Physical Therapist - Pediatrics | 070.013454 | IL |
NPI | 1023160694 |
---|---|
Provider Name | Ms. Sandra M. Barlow |
First Address | Chicago, IL 60641 |
Second Address | Chicago, IL 60649-1395 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 04/02/2009 |