MRS. THERESA LYNN FITZGERALD (NPI# 1902924590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902924590 |
| Entity Type | Individual |
| Full Name | MRS. THERESA LYNN FITZGERALD |
| Credential | D.T. |
| Practice Address |
6301 South Unity Road Polo IL 61064-9304 |
| Mailing Address |
6301 S Unity Rd Polo IL 61064-9304 |
| Practice Telephone | 8159463402 |
| Practice Fax Number | 8159463402 |
| Mailing Telephone | 8159463402 |
| Mailing Fax Number | 8159463402 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 178002457 | IL | Behavioral Health & Social Service Providers |
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952314759 | Theresa Ann Fitzgerald | Chiropractor | 2904 Rowena Ave, Los Angeles, CA 90039-2042 | 2006-08-14 |
| 1376093732 | Theresa Fitzgerald | Occupational Therapist | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2016-10-10 |
| 1861830184 | Theresa Fitzgerald | Occupational Therapy Assistant | 5405 Babcock St Ne, Palm Bay, FL 32905-5020 | 2013-06-08 |
| 1649588344 | Theresa Blum Fitzgerald | Dietitian, Registered | 4214 Andrews Hwy, Suite 101, Midland, TX 79703-4822 | 2010-09-16 |
| 1508096256 | Theresa Mangahas Fitzgerald | Family Medicine | 3901 Hoyt Ave, Everett, WA 98201 | 2009-07-15 |
| 1417181942 | Theresa Ann Fitzgerald | Social Worker | 3900 Church Rd, Mount Laurel, NJ 08054-1108 | 2009-05-12 |
| Street Address |
6301 SOUTH UNITY ROAD |
| City | POLO |
| State | IL |
| Zip Code | 61064-9304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225088172 | Henry Oh | Family Medicine | 711 Division St., Polo, IL 61064 | 2006-05-11 |
| 1669443966 | Debra C Drengenberg | Family Medicine | 1107 S. Division Ave., Ksb Center for Health Services/polo, Polo, IL 61064 | 2006-01-27 |
| 1689024853 | Jeanette M Trotter | Counselor | 115 W Mason St Ste 201, Polo, IL 61064-1501 | 2016-06-17 |
| 1174096028 | Polo Pharmacy, Inc. | Pharmacy | 111 E Mason St, Polo, IL 61064-1521 | 2019-01-03 |
| 1023154630 | Felker Pharmacy Inc | Pharmacy | 110 E Mason St, Polo, IL 61064-1522 | 2007-01-30 |
| 1295732360 | Mid Americacare Foundation | Skilled Nursing Facility | 703 E Buffalo St, Polo, IL 61064-1701 | 2005-07-05 |
| 1912546847 | Polo Hco LLC | Skilled Nursing Facility | 703 E Buffalo St, Polo, IL 61064-1701 | 2019-12-23 |
| 1275184624 | Karen Sue Williams | Physical Therapy Assistant | 703 E Buffalo St, Polo, IL 61064-1701 | 2019-09-26 |
| 1164083630 | Karina Nehrkorn | Speech-Language Pathologist | 703 E Buffalo St, Polo, IL 61064-1701 | 2019-06-25 |
| 1972093292 | Mubaraka Bootwala | Occupational Therapist | 703 E Buffalo St, Polo, IL 61064-1701 | 2018-05-11 |
| Find all providers in zip 61064 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922813 | Valerie Ann Taylor | Counselor | 1230 N Washington Ave, Batavia, IL 60510-1369 | 2020-11-07 |
| 1073114088 | Astrid Larsen | Counselor | 2317 Timberline Trl, Woodstock, IL 60098-8759 | 2020-11-05 |
| 1932708690 | Mucci World Management Inc,. | Counselor | 7913 171st St, Tinley Park, IL 60477-3244 | 2020-10-22 |
| 1679172373 | Alexander Czop | Counselor | 1250 Chestnut Ave, Wilmette, IL 60091-1616 | 2020-10-22 |
| 1427656859 | Mica Coleman | Counselor | 5800 Allemong Dr, Matteson, IL 60443-1108 | 2020-10-16 |
| 1386242873 | Kelly Mann | Counselor | 301 S Henry St, Ashkum, IL 60911-7119 | 2020-10-15 |
| 1245838549 | Erika Leigh Heatley | Counselor | 32w755 Albert Dr, East Dundee, IL 60118-3202 | 2020-10-09 |
| 1851999080 | Linda D Odaniel | Counselor | 12904 Division St Apt 2a, Blue Island, IL 60406-3420 | 2020-10-09 |
| 1366058075 | Allyssa Rose Bertram | Counselor | 4055 W Peterson Ave Ste 202, Chicago, IL 60646-6183 | 2020-09-17 |
| 1952914707 | Tara Ufer | Counselor | 400 W Deming Pl Apt 9g, Chicago, IL 60614-1702 | 2020-08-30 |
| 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.