Healthcare Provider Details

I. General information

NPI: 1952352775
Provider Name (Legal Business Name): CINDY E THUROW PPA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 CLUB CIR
BELVIDERE IL
61008-8222
US

IV. Provider business mailing address

5238 LAKECREST RD
CALEDONIA IL
61011-9042
US

V. Phone/Fax

Practice location:
  • Phone: 815-544-1453
  • Fax:
Mailing address:
  • Phone: 815-621-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: