Sabreen Dassa
Individual provider Active NPI Developmental Therapist · Macomb, IL
NPI 1073964086 · NPPES record last updated Jan 10, 2018
Key facts
- NPI
- 1073964086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 1 University Cir
Macomb, IL 61455-1367 - Phone
- (309) 298-3066
- NPI assigned
- Jun 30, 2016
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | IL | Yes |
Addresses
Primary practice location
1 University Cir
Macomb, IL 61455-1367
Mailing address
15232 Linden Dr
Oak Forest, IL 60452-1507
Phone (708) 983-4580
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073964086 | Medicaid | IL |
Other providers in Macomb, IL
- David R. Culver
- Thomas George Cummings
- Kelsi D Cunningham
- Khaled A Dabash
- Sara S Damra
- David R Culver OD LTD
- Denman Services, Inc
- Marilyn Kay Derry
- Rebecca E Derry
- Jon Karl Dively
All providers in Macomb, IL · Developmental 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 Jan 10, 2018. 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.