Michelle Lee Cedergren

Individual provider Active NPI Developmental Therapist · Worth, IL

NPI 1053969170 · NPPES record last updated Sep 2, 2019

Key facts

NPI
1053969170
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
11327 S Natoma Ave
Worth, IL 60482-2129
Phone
(708) 227-0245
NPI assigned
Sep 2, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

11327 S Natoma Ave
Worth, IL 60482-2129

Mailing address

11327 S Natoma Ave
Worth, IL 60482-2129
Phone (708) 227-0245

Other providers in Worth, IL

All providers in Worth, IL · Developmental Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.