Provider Demographics
NPI:1114152576
Name:RUMAGE, ANITA JEAN
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:JEAN
Last Name:RUMAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 STONY KNLS
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61019-9380
Mailing Address - Country:US
Mailing Address - Phone:815-865-9049
Mailing Address - Fax:815-865-9049
Practice Address - Street 1:112 STONY KNLS
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:IL
Practice Address - Zip Code:61019-9380
Practice Address - Country:US
Practice Address - Phone:815-865-9049
Practice Address - Fax:815-865-9049
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist