Rozine Gibson
Individual provider Active NPI Developmental Therapist · Sauk Village, IL
NPI 1326699174 · NPPES record last updated Sep 24, 2019
Key facts
- NPI
- 1326699174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 279 Mallard Dr
Sauk Village, IL 60411-6788 - Phone
- (708) 577-8225
- NPI assigned
- Sep 24, 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
279 Mallard Dr
Sauk Village, IL 60411-6788
Mailing address
279 Mallard Dr
Sauk Village, IL 60411-6788
Phone (708) 577-8225
Other providers in Sauk Village, IL
- Curtis J Edwards
- Johnie Mae Epps
- Fresh Start Behaviorial Center
- Paula Galmore
- Shaun Reeves Gary
- Brenda Frances Harris
- Owin S. Henry
- Elesa Hodges
- Huemanity Homes, Inc
- Latrice Jackson
All providers in Sauk Village, 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 Sep 24, 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.