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NPI Code Detail

MEDICARE: ANGELA THERESA PARHAM RBT

MEDICARE: ANGELA THERESA PARHAM RBT
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
2106S00000XBehavior Technician22-226519IL

General Provider Information

NPI Number : 1306572003
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA THERESA PARHAM RBT
Provider Business Mailing Address
First Line : 4348 MANN ST
Second Line :
City : OAK FOREST
State : IL
Zip : 60452-4329
Country : US
Telephone Number : 773-575-2845
Fax Number :
Provider Business Practice Location Address
First Line : 4501 HILL RD
Second Line :
City : HIGHLAND
State : IL
Zip : 62249-3519
Country : US
Telephone Number : 618-830-6562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2022
Last Update Date : 01/29/2025

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Directions to “ ANGELA THERESA PARHAM RBT” Practice Location

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