Individual provider · NPI-1
Rebecca Ellen Gerdes, M.S., D.T.
Developmental Therapist · Elgin, IL
NPI number1174710032
StatusActive
Last updated in NPPESSep 25, 2007
Details
- NPI
- 1174710032
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Rebecca Ellen Gerdes
- Credential
- M.S., D.T.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 25, 2007
- Last updated
- Sep 25, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | RG21470903p | IL | Yes |
Practice location
635 N Grove AveElgin, IL 60120-2803
Phone 630-440-1015 · Fax 847-841-8529
Mailing address
635 N Grove AveElgin, IL 60120-2803
Phone 630-440-1015 · Fax 847-841-8529
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.