Provider Demographics
NPI:1427069145
Name:DISABILITY MANAGEMENT NETWORK
Entity type:Organization
Organization Name:DISABILITY MANAGEMENT NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MARA
Authorized Official - Suffix:
Authorized Official - Credentials:COHN-S, CCM
Authorized Official - Phone:815-262-0442
Mailing Address - Street 1:6723 WEAVER RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8052
Mailing Address - Country:US
Mailing Address - Phone:815-633-0880
Mailing Address - Fax:815-633-4740
Practice Address - Street 1:6723 WEAVER RD.
Practice Address - Street 2:STE. 108
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8052
Practice Address - Country:US
Practice Address - Phone:815-633-0880
Practice Address - Fax:815-633-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management