Individual
CASEY DANA RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2820 WILLOW RD, HOMEWOOD, IL 60430-2821
(708) 207-1467
Mailing address
2820 WILLOW RD, HOMEWOOD, IL 60430-2821
(708) 207-1467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013624
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063868586
—
IL
Enumeration date
08/14/2018
Last updated
01/22/2021
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