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General NPI Number Information
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NPI Number | 1851594352
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Entity Type | Individual
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Provider Name | TANZIE CAGE
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 287 CLARIDGE CIR
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City | BOLINGBROOK
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State | IL
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Zip | 60440-6184
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Country | US
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Telephone | 630-759-6673
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 WISCONSIN AVE 1ST FLOOR
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City | BERWYN
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State | IL
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Zip | 60402-1253
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Country | US
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Telephone | 708-494-0067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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