Healthcare Provider Details

I. General information

NPI: 1053264945
Provider Name (Legal Business Name): MILA ROSE SAJOVEC BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 FRANKLIN AVE STE L500
NORMAL IL
61761-3551
US

IV. Provider business mailing address

1302 FRANKLIN AVE STE L500
NORMAL IL
61761-3551
US

V. Phone/Fax

Practice location:
  • Phone: 309-452-0069
  • Fax: 309-451-8989
Mailing address:
  • Phone: 309-452-0069
  • Fax: 309-451-8989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: