Individual
EVIE ROSADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
711 E JACKSON ST, JOLIET, IL 60432-2540
(815) 325-2376
Mailing address
1516 PHOENIX LN, JOLIET, IL 60431-8417
(815) 325-2376
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.015397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227.015397
ILDPH MASSAGE THERAPIST LICENSE NUMBER
IL
01
—
MA89150
FL DEPARTMENT OF HEALTH
FL
01
—
MT21906775
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
01/30/2020
Last updated
01/30/2020
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