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NPI Code Detail

MEDICARE: MRS. MARLA JOY GARSTKA

MEDICARE: MRS. MARLA JOY GARSTKA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1073634671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARLA JOY GARSTKA
Provider Business Mailing Address
First Line : 338 HADDON CIR
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-2920
Country : US
Telephone Number : 847-816-4531
Fax Number :
Provider Business Practice Location Address
First Line : 1850 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1228
Country : US
Telephone Number : 312-666-1331
Fax Number : 312-506-0103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 07/08/2007

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