Individual
NICOLE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
19815 GOVERNORS HWY STE 1A, FLOSSMOOR, IL 60422-4321
(708) 927-3400
Mailing address
21155 MAPLE ST, MATTESON, IL 60443-2529
(708) 927-3400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227020807
IL
376J00000X
Homemaker
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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