Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | IL |
NPI | 1356371181 |
---|---|
Provider Name | Ms. Cheryl Joy Rokos |
First Address | Springfield, IL 62704-5716 |
Second Address | Springfield, IL 62702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |