Basic Information
| Provider Information | |||||||||
| NPI: | 1558994533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROJAS | ||||||||
| FirstName: | LAARNIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 TRILLIUM LN | ||||||||
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| City: | SHOREWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604049531 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 SPRINGFIELD AVE | ||||||||
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| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604356589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157253400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2020 | ||||||||
| LastUpdateDate: | 02/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 160.007819 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.