Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANITA JOHANSON MADDOX, LCPC
ActiveANITA JOHANSON MADDOX, LCPC is a Developmental Therapist healthcare provider located in LAKE VILLA, Illinois. NPI 1770623407 is currently active in the NPPES registry. Verify at CMS.
Developmental Therapist · LAKE VILLA, IL
Registration Details
- NPI Number
- 1770623407
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 8, 2007 (19.328308180312 yrs)
- Last Updated
- Sep 21, 2010
- Licenses
-
180004644 (IL)AM47190798P (IL)
Practice Information
- Address
-
89 CEDAR AVELAKE VILLA, IL, 600468411Browse IL providers · Browse ZIP 60046
- Phone
- 8472657300
- Fax
- 8472657301
- Primary Specialty
-
Developmental Therapist
222Q00000X
- Additional Specialty
- Developmental Therapist
Other Developmental Therapist Providers in LAKE VILLA, IL
| Name | Credential | NPI |
|---|---|---|
| DEANA LYNN JAROS | DT | 1760682876 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.