Healthcare Provider Details
I. General information
NPI: 1679770721
Provider Name (Legal Business Name): EMILY ANNE ROPARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6006 159TH ST BLDG B
OAK FOREST IL
60452-2904
US
IV. Provider business mailing address
5645 W DAKIN ST APT 2
CHICAGO IL
60634-2736
US
V. Phone/Fax
- Phone: 708-535-0933
- Fax: 708-614-9435
- Phone: 630-696-1898
- Fax: 708-614-9435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 222Q00000X |
| Taxonomy | Developmental Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: