Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | IL |
NPI | 1013131192 |
---|---|
Provider Name | Jane S Corabi |
First Address | Worth, IL 60482-1419 |
Second Address | Orland Park, IL 60467-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |