Provider Demographics
NPI:1861227761
Name:CORRADO, ERIN L (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:CORRADO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LYNN
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:332 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3218
Mailing Address - Country:US
Mailing Address - Phone:847-440-6459
Mailing Address - Fax:
Practice Address - Street 1:332 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-3218
Practice Address - Country:US
Practice Address - Phone:847-440-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist