Roxanne K Dierolf, LMT
Individual provider Active NPI Massage Therapist · Sherrard, IL
NPI 1063727329 · NPPES record last updated Aug 11, 2010
Key facts
- NPI
- 1063727329
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227.011221 (IL)
- Practice address
- 405 3Rd St
Suite B
Sherrard, IL 61281-7706 - Phone
- (309) 593-9112
- NPI assigned
- Aug 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.011221 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reflexologist | 173C00000X | |||
| Massage Therapist | 225700000X | 227.011221 | IL | Yes |
Addresses
Primary practice location
405 3Rd St
Suite B
Sherrard, IL 61281-7706
Mailing address
405 3Rd St
P.O. Box 511
Sherrard, IL 61281-7706
Phone (309) 593-9112
Other providers in Sherrard, IL
- Grant Duncan
- Steven Menegus
- Revival Health
- Sherrard Comm Unit SCH Dis 200
- Sherrard Fire Protection District
All providers in Sherrard, IL · Massage Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.