Robyn Marie Gansemer, L.M.T.
Individual provider Active NPI Massage Therapist · Colona, IL
NPI 1457592503 · NPPES record last updated Mar 19, 2009
Key facts
- NPI
- 1457592503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227-009577 (IL)
- Practice address
- 532 Green Park Ave Apt 6
Colona, IL 61241-9633 - Phone
- (309) 796-3970
- Fax
- (309) 796-3972
- NPI assigned
- Mar 19, 2009
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227-009577 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227-009577 | IL | Yes |
Addresses
Primary practice location
532 Green Park Ave Apt 6
Colona, IL 61241-9633
Mailing address
532 Green Park Ave Apt 6
Colona, IL 61241-9633
Phone (309) 796-3970
Other providers in Colona, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2009. 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.