Provider Demographics
NPI:1053509661
Name:CONSOLO, MARIA ARCE (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ARCE
Last Name:CONSOLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA LEA
Other - Middle Name:ACLO
Other - Last Name:ARCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4370 BLUE DIAMOND RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7787
Practice Address - Country:US
Practice Address - Phone:702-443-9301
Practice Address - Fax:702-342-0600
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015304174400000X, 225100000X
NV225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist