Stephanie Clifton

Individual provider Active NPI Massage Therapist · Midlothian, IL

NPI 1538472147 · NPPES record last updated Jul 23, 2010

Key facts

NPI
1538472147
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
227007944 (IL)
Practice address
3824 147TH St
Midlothian, IL 60445-3462
Phone
(708) 374-3778
NPI assigned
Jul 23, 2010
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

LicenseStateTypeSpecialty
227007944ILMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225700000X 227007944 IL Yes

Addresses

Primary practice location

3824 147TH St
Midlothian, IL 60445-3462

Mailing address

3824 147TH St
Midlothian, IL 60445-3462
Phone (708) 374-3778

Other providers in Midlothian, IL

All providers in Midlothian, IL · Massage Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.