Provider Demographics
NPI:1598853673
Name:ROJAS, NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4249
Mailing Address - Country:US
Mailing Address - Phone:630-850-7565
Mailing Address - Fax:630-850-7537
Practice Address - Street 1:105 E 1ST ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4249
Practice Address - Country:US
Practice Address - Phone:630-850-7565
Practice Address - Fax:630-850-7537
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist