Provider Demographics
NPI:1962919480
Name:TOEBAAS, ERIKA MARY (LAC, DAOM)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARY
Last Name:TOEBAAS
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 N SAINT MARYS RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1634
Mailing Address - Country:US
Mailing Address - Phone:773-443-3809
Mailing Address - Fax:
Practice Address - Street 1:51 SHERWOOD TER STE 51H
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2232
Practice Address - Country:US
Practice Address - Phone:312-554-5709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002490171100000X
CAAC17657171100000X
IL227.022724225700000X
CO0024108225700000X
IL198001599171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist