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
| License | State | Type | Specialty |
|---|---|---|---|
| 227007944 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
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
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- Brenna Maureen Conlon
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All providers in Midlothian, IL · Massage 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 Jul 23, 2010. 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.