Carol June Easley

Individual provider Active NPI Day Training/Habilitation Specialist · Beardstown, IL

NPI 1568940971 · NPPES record last updated Jul 30, 2018

Key facts

NPI
1568940971
Entity type
Individual (NPI type 1)
Primary specialty
Day Training/Habilitation Specialist 373H00000X
Practice address
121 E 2ND St
Beardstown, IL 62618-1263
Phone
(217) 323-2980
Fax
(217) 323-3771
NPI assigned
Jul 30, 2018
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)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X Yes

Addresses

Primary practice location

121 E 2ND St
Beardstown, IL 62618-1263

Mailing address

121 E 2ND St
Beardstown, IL 62618-1263
Phone (217) 323-2980

Other providers in Beardstown, IL

All providers in Beardstown, IL · Day Training/Habilitation Specialist in Illinois

Sources for this page

Verify at the official NPI Registry.