Healthcare Provider Details

I. General information

NPI: 1831711209
Provider Name (Legal Business Name): ROCHELLE SWILLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7658 BELAIR RD STE A
BALTIMORE MD
21236-4020
US

IV. Provider business mailing address

215 SHUMAN BLVD STE 401
NAPERVILLE IL
60563-8123
US

V. Phone/Fax

Practice location:
  • Phone: 410-668-9198
  • Fax: 668-410-9198
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02845
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: