DR. LYNETTE MAE CARLSON (NPI# 1821063017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821063017 |
| Entity Type | Individual |
| Full Name | DR. LYNETTE MAE CARLSON |
| Credential | DHS, ATC |
| Practice Address |
635 Executive Dr Willowbrook IL 60527-5603 |
| Mailing Address |
1131 Stringers Ridge Rd Apt 2k Chattanooga TN 37405-3238 |
| Practice Telephone | 6304556630 |
| Practice Fax Number | 6304556631 |
| Mailing Telephone | 6306742584 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2017-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
528 | TN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096.002040 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871822320 | Lynette Rene Carlson | Speech-Language Pathologist | 31 W College St, 174 Chester Park, Duluth, MN 55812-1106 | 2009-12-11 |
| 1700157609 | Lynette J Carlson | Counselor | 325 E Pioneer Ave, Puyallup, WA 98372-3265 | 2012-01-24 |
| Street Address |
635 EXECUTIVE DR |
| City | WILLOWBROOK |
| State | IL |
| Zip Code | 60527-5603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437315900 | Bryan T Scheffers | Physical Therapist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2008-08-04 |
| 1225233091 | Michael C Walter | Specialist/Technologist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2007-06-20 |
| 1053516088 | Scott M Wirth | Physical Therapist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2007-06-19 |
| 1366534877 | Amanda J Houk | Physical Therapist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2006-09-29 |
| 1942392469 | Michelle L Quillin | Physical Therapist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023635364 | Crystal Mary Dirks | Occupational Therapy Assistant | 211 75th St, Burr Ridge, IL 60527 | 2020-07-02 |
| 1386276350 | Valerie Moreno-tucker | Counselor | 277 83rd St, Burr Ridge, Il 60527, Burr Ridge, IL 60527 | 2020-02-07 |
| 1831734763 | Annette Maria Zajac | Occupational Therapist | 16 91st St., Burr Ridge, IL 60527 | 2019-11-14 |
| 1568023109 | Jennifer Rogers | Counselor | 277 83rd St., Ste. D, Burr Ridge, IL 60527 | 2019-06-25 |
| 1710458526 | Dima Sibai Dds PC | Clinic/Center | 940 Plianfield Rd., Willowbrook, IL 60527 | 2018-12-06 |
| 1558850495 | Jeanie C. Lucy PC | Optometrist | 6340 Americana Drive Suite 1108, Willowbrook, IL 60527 | 2018-05-07 |
| 1538664032 | Athletico,ltd | Physical Therapist | 6860 N Frontage Rd Ste B, Burr Ridge, IL 60527 | 2018-03-27 |
| 1003314832 | Ams Wellness Pllc | Psychologist | 277 83rd St Ste D, Burr Ridge, IL 60527 | 2018-01-26 |
| 1023564671 | Natasa Manasovska | Dentist | 6111 Knollwood Rd, Apt. 103, Willowbrook, IL 60527 | 2016-09-01 |
| 1669927893 | Marie Ann Korallus | Nurse Practitioner | 7055 High Grove, Burr Ridge, IL 60527 | 2016-08-17 |
| Find all providers in zip 60527 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770871808 | Miriam K Boeing | Specialist/Technologist | 7191 S Kingery Hwy, Suite L6, Willowbrook, IL 60527-5525 | 2011-07-11 |
| 1093949950 | Matthew Holton | Specialist/Technologist | 7191 S Kingery Hwy, Ste L6, Willowbrook, IL 60527-5525 | 2009-05-07 |
| 1225233091 | Michael C Walter | Specialist/Technologist | 635 Executive Dr, Willowbrook, IL 60527-5603 | 2007-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
| Find all providers with the same taxonomy | ||||
| City | WILLOWBROOK |
| Zip Code | 60527 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.