Cheryl Ann Blaz
Individual provider Active NPI Physical Therapist · Mundelein, IL
NPI 1063979979 · NPPES record last updated Feb 27, 2019
Key facts
- NPI
- 1063979979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070.002558 (IL)
- Practice address
- 500 Acorn LN
Mundelein, IL 60060-4019 - Phone
- (847) 566-9221
- NPI assigned
- Feb 27, 2019
- 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 |
|---|---|---|---|
| 070.002558 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 070.002558 | IL | Yes |
Addresses
Primary practice location
500 Acorn LN
Mundelein, IL 60060-4019
Mailing address
17273 W Dartmoor Dr
Grayslake, IL 60030-3010
Phone (847) 845-8798
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070.002558 | Other | IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
Other providers in Mundelein, IL
- Behavioral Services Center
- Patricia A Belleno
- Cara Rosemary Benes
- Tatyana Benes
- Better Home Senior Care, Inc.
- Khaled Bleibel
- Paul Michael Blidy
- Steven Jeffrey Blum
- Thibault Bordeau
- Natasha Bosch
All providers in Mundelein, IL · Physical 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 Feb 27, 2019. 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.