Mia Beth Deroin, D.O.

Individual provider Active NPI Developmental Therapist · Harwood Heights, IL

NPI 1306254271 · NPPES record last updated Jul 23, 2014

Key facts

NPI
1306254271
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
4412 N Oak Park Ave
Harwood Heights, IL 60706-4836
Phone
(630) 673-9499
NPI assigned
Jul 23, 2014
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
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X IL Yes

Addresses

Primary practice location

4412 N Oak Park Ave
Harwood Heights, IL 60706-4836

Mailing address

320 W Oakdale Ave
Chicago, IL 60657-6419
Phone (773) 871-5926

Other providers in Harwood Heights, IL

All providers in Harwood Heights, IL · Developmental Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.