Doctor Name: | REBECCA BACKHUS |
NPI Number: | 1437520913 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 171WH0202X |
Business Practice Address: | 206 W Wall St Apt 1 Morrison, IL - 612702300 |
Business Phone Number: | 8154994692 |
Business Fax Number: | |
Mailing Address: | 206 W Wall St Apt 1, MORRISON |
State: | IL |
Postal Code: | 612702300 |
Phone Number: | 8154994692 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | 171WH0202X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |