Roggenbuck, Jacquelyn Marie
Roggenbuck, Jacquelyn Marie is an individual health care provider with primary practice located at 324 Roxbury Road , Rockford IL 61107. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Roggenbuck, Jacquelyn Marie can be contacted via phone (815) 398-9491.Contact Information
Primary practice address
324 Roxbury Road
Rockford IL 61107
Phone: (815) 398-9491
Fax: (815) 381-7498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 056-011026 | Illinois |
Profile Details
| NPI number | 1063625820 |
|---|---|
| LBN Legal business name | Roggenbuck, Jacquelyn Marie |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2007 |
| Last updated | Sep 13th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063625820 | NPPES |
| Wisconsin | MEDICAID | 41046100 |
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