Doctor Name: | MRS. CHARLENE KATHRYN HUDSON |
NPI Number: | 1790026334 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 227.013510 |
Business Practice Address: | 3329 Vollmer Rd Flossmoor, IL - 604222003 |
Business Phone Number: | 7082062750 |
Business Fax Number: | |
Mailing Address: | 617 Clover Lane, UNIVERSITY PARK |
State: | IL |
Postal Code: | 60484 |
Phone Number: | 7088338377 |
Fax Number: | |
NPI Enumeration Date: | 03/06/2013 |
NPI Last Update Date: | 03/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 227.013510 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |