MEDICARE: MADISON AMANDA GATZ RBT-18-48805

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
1	106S00000X	Behavior Technician	RBT-18-48805	IL

General Provider Information

NPI Number	:	1992295034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON AMANDA GATZ RBT-18-48805

Provider Business Mailing Address
First Line	:	1853 WOODLAWN RD
Second Line	:
City	:	STEWARD
State	:	IL
Zip	:	60553-9755
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1853 WOODLAWN RD
Second Line	:
City	:	STEWARD
State	:	IL
Zip	:	60553-9755
Country	:	US
Telephone Number	:	815-901-5126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	05/15/2018

Similar Medicare Providers

1962604470 — STEWARD DISTRICT 220
Practice Location Address:

PERRY RD SCHOOL ST
STEWARD, IL
60553-0000

Practice Phone: 815-284-6651
Practice Fax:

1447821558 — NICOLE KEDZIE CPM
Practice Location Address:

1818 QUAIL HOLLOW RD
STEWARD, IL
60553-9775

Practice Phone: 630-802-1869
Practice Fax:

1568557189 — MRS. BRIDGET L JOHNSON PT OCS
Practice Location Address:

404 W BLACKHAWK DRIVE , SUITE 1U
BYRON, IL
61010

Practice Phone: 815-234-5561
Practice Fax: 815-234-5870

1639680895 — JILL KAE KANE MA/CCC-SLP
Practice Location Address:

1450 20TH ST
ROCHELLE, IL
61068-1076

Practice Phone: 815-562-4520
Practice Fax:

1114401833 — JENNIFER TARVESTAD FNP-BC
Practice Location Address:

1850 GATEWAY DR
SYCAMORE, IL
60178-3192

Practice Phone: 815-758-8671
Practice Fax: 815-756-4892

1447258421 — CITY OF LUDLOW
Practice Location Address:

234 OAK STREET
LUDLOW, KY
41016-1415

Practice Phone: 859-581-8600
Practice Fax: 859-581-8602

Directions to “ MADISON AMANDA GATZ RBT-18-48805” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.