Kimberly Karen Roediger, LMT
Individual provider Active NPI Massage Therapist · Peotone, IL
NPI 1932408804 · NPPES record last updated Mar 17, 2011
Key facts
- NPI
- 1932408804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227.001582 (IL)
- Practice address
- 408 N Glenview LN
Peotone, IL 60468-9233 - Phone
- (708) 785-6952
- NPI assigned
- Mar 17, 2011
- 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 |
|---|---|---|---|
| 227.001582 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.001582 | IL | Yes |
Addresses
Primary practice location
408 N Glenview LN
Peotone, IL 60468-9233
Mailing address
408 N Glenview LN
Peotone, IL 60468-9233
Phone (708) 785-6952
Other providers in Peotone, IL
- Arthur B. Pasquinelli
- Peotone Community Unit School District #207-U
- Tabitha Peppmuller
- Candy Quinn
- Riverside Medical Center
- Scott R Lowry DO 2, LLC
- Madilyn Abigail Seyller
- Bria Stubblefield
- Teske Family Chiropractic Center LTD
- Brenda Sue Teske
All providers in Peotone, 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 Mar 17, 2011. 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.