MRS. JAMIE LYNN FANARA (NPI# 1174813398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174813398 |
| Entity Type | Individual |
| Full Name | MRS. JAMIE LYNN FANARA |
| Credential | JAMIE FANARA, LCMT |
| Practice Address |
461 N. Mulford Road Unit 8 Rockford IL 61107 |
| Practice Telephone | 8159774743 |
| Mailing Telephone | 8159774743 |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 227.005581 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
461 N. MULFORD ROAD UNIT 8 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639265259 | Mohammad Asim Mustafa | Pediatrics | 461 N. Mulford Road, Suite 12, Rockford, IL 61107-5165 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| 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 |
|---|---|---|---|---|
| 1902411325 | Todd M Genovese | Massage Therapist | 3209 Twin Ridge Ln, Rockford, IL 61109-3866 | 2020-09-11 |
| 1558980797 | Christy Ann Cellitti | Massage Therapist | 2222 E State St Ste A98, Rockford, IL 61104-1572 | 2020-04-08 |
| 1922452572 | Sarah Deur | Massage Therapist | 7500 Agawa Trl Ne, Rockford, MI 49341-8524 | 2016-04-20 |
| 1366801664 | Lorri Ann Kelbel | Massage Therapist | 11591 Northland Drive Ne, Rockford, MI 49341 | 2016-02-15 |
| 1225413073 | Hannah Grissom | Massage Therapist | 11591 Northland Dr Ne, Rockford, MI 49341-8426 | 2015-07-22 |
| 1144618984 | Maria Natalia Corales | Massage Therapist | 519 Parkside Dr, Rockford, IL 61108-2024 | 2015-01-01 |
| 1427318831 | Paulette Jeronimus | Massage Therapist | 4616 Newcastle Rd, Rockford, IL 61108-7714 | 2012-05-18 |
| 1851673669 | Nadene Johnson | Massage Therapist | 1917 E Gate Pkwy, Rockford, IL 61108-5915 | 2011-09-16 |
| 1578852216 | Robin J Debenedetto | Massage Therapist | 4967 Cardamon Ln, Rockford, IL 61114-5323 | 2011-04-04 |
| 1366744963 | Kelli Boehning | Massage Therapist | 429 Phelps Ave, Bldg. 7 Ste. 711, Rockford, IL 61108-2493 | 2010-12-02 |
| Find all providers in ROCKFORD | ||||
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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.