Ms Theresa Rose Stark, LMT, BCTMB is a
Massage Therapist based in Evergreen Park, Illinois. Ms Theresa Rose Stark is licensed to practice in Illinois (license number 227-008050) and her current practice location is
3850 W 95th Street, Evergreen Park, Illinois. She can be reached at her office (for appointments etc.) via phone at
(773) 556-5333.
NPI number for Ms Theresa Rose Stark is 1275774788 and her current mailing address is 3850 W 95th Street, Evergreen Park, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275774788.
Healthcare Provider's Profile
| Full Name | Ms Theresa Rose Stark |
|---|
| Gender | Female |
|---|
| Speciality | Massage Therapist |
|---|
| Location | 3850 W 95th Street, Evergreen Park, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1275774788
- Provider Enumeration Date: 03/12/2009
- Last Update Date: 09/21/2018
Medical Identifiers
Medical identifiers for Ms Theresa Rose Stark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1275774788 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 225700000X | Massage Therapist | 227-008050 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Theresa Rose Stark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ms Theresa Rose Stark, LMT, BCTMB 3850 W 95th Street, Evergreen Park, IL 60805-2034 Ph: (773) 556-5333 | Ms Theresa Rose Stark, LMT, BCTMB 3850 W 95th Street, Evergreen Park, IL 60805-2034 Ph: (773) 556-5333 |
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