MR. DERRICK D DITZLER (NPI# 1174806590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174806590 |
| Entity Type | Individual |
| Full Name | MR. DERRICK D DITZLER |
| Credential | LMT |
| Practice Address |
59 S Nina St Cortland IL 60112-4047 |
| Practice Telephone | 8157937737 |
| Mailing Telephone | 8157937737 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 227012825 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
59 S NINA ST |
| City | CORTLAND |
| State | IL |
| Zip Code | 60112-4047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952688046 | Cortland Community Firemans Association | Ambulance | 30 W North Ave, Cortland, IL 60112 | 2011-11-03 |
| 1851588743 | Trina Teckenburg | Physical Therapist | 616 Broad Street, Grinnell, IA 60112 | 2007-09-25 |
| 1528420346 | Megan Orr | Social Worker | 138 E Lark Ave, Cortland, IL 60112-4034 | 2016-03-22 |
| 1407205685 | Cortland Community Fire Protection District | Ambulance | 30 W North Ave, Cortland, IL 60112-4051 | 2016-06-08 |
| 1003444134 | Stacy Lyn Rotramel | Behavior Technician | 10 W South Ave, Cortland, IL 60112-4072 | 2020-04-01 |
| 1033523840 | Heather Poeschel | Specialist/Technologist | 199 E Warbler Ave, Cortland, IL 60112-4084 | 2014-06-19 |
| 1952787137 | John Watson | Counselor | 151 N Aspen Dr, Cortland, IL 60112-4100 | 2015-08-10 |
| 1548667413 | Cory Andrew Lesniak | Specialist/Technologist | 178 N Aspen Dr, Cortland, IL 60112-4100 | 2014-11-20 |
| 1790830123 | Monique Luisa Heilemeier | Counselor | 88 W Ellen Ave, Cortland, IL 60112-4119 | 2007-01-24 |
| 1700096179 | Lora Michelle Labadi | Developmental Therapist | 212 W Ellen Ave, Cortland, IL 60112-4120 | 2007-05-23 |
| Find all providers in zip 60112 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356801674 | Mollie Thomas | Massage Therapist | 17 Main St Ste Ll12, Cortland, NY 13045-6617 | 2019-03-22 |
| 1417462920 | Global Heart Healing and Massage | Massage Therapist | 11 Tompkins St Ste 17, Cortland, NY 13045-2563 | 2017-12-06 |
| 1639697147 | Toner Therapeutic Massage | Massage Therapist | 17 Main St Ste 218, Cortland, NY 13045-6618 | 2017-09-05 |
| 1346693587 | Nicole Marie Fox Toner | Massage Therapist | 17 Main St, Ste 218, Cortland, NY 13045-6606 | 2016-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627872 | Patricia Pollard | Massage Therapist | 4437 N Lowell Ave Apt 2, Chicago, IL 60630-4103 | 2020-10-23 |
| 1497354104 | Lola Sanders | Massage Therapist | 844 Wilshire Dr, Belleville, IL 62223-2623 | 2020-10-22 |
| 1003415001 | Amanda L Klimczak | Massage Therapist | 1231 Ridgeland Ave, Berwyn, IL 60402-1142 | 2020-10-21 |
| 1093314148 | Jody Lee Hazel | Massage Therapist | 1750 E Colborn Camp Ln, Noble, IL 62868-2348 | 2020-10-20 |
| 1194323352 | Vanina Barnett | Massage Therapist | 112 Sussex Cir, Schaumburg, IL 60193-1835 | 2020-10-10 |
| 1063029676 | Natasha White | Massage Therapist | 8235 S Kingston Ave, Chicago, IL 60617-1909 | 2020-09-28 |
| 1407463029 | Danielle Wright | Massage Therapist | 132 S Water St Ste 430, Decatur, IL 62523-2305 | 2020-09-28 |
| 1316554272 | Paula Marie Zaloga-nowak | Massage Therapist | 4942 N Melvina Ave, Chicago, IL 60630-2908 | 2020-09-24 |
| 1780291872 | Jennifer Marshall | Massage Therapist | 6920 W 110th St, Worth, IL 60482-1425 | 2020-09-23 |
| 1326654690 | Helene Decourchelle | Massage Therapist | 3524 N Marshfield Ave Ph, Chicago, IL 60657-1248 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.