MRS. MELYNDA RAE COSTA (NPI# 1124379961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124379961 |
| Entity Type | Individual |
| Full Name | MRS. MELYNDA RAE COSTA |
| Other Name | MISS MELYNDA RAE BLAYLOCK |
| Practice Address |
26448 S Edinburg Ct Channahon IL 60410-5598 |
| Practice Telephone | 8155210372 |
| Practice Fax Number | 8155210372 |
| Mailing Telephone | 8155210372 |
| Mailing Fax Number | 8155210372 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
26448 S EDINBURG CT |
| City | CHANNAHON |
| State | IL |
| Zip Code | 60410-5598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841792801 | Rhonda Richter | Health Educator | 24735 W. Eames St., Channahon, IL 60410 | 2018-03-06 |
| 1144513938 | Channahon Dui Services, LLC | Early Intervention Provider Agency | 23157 Thomas Dillon Drive, Channahon, IL 60410 | 2011-05-26 |
| 1205057452 | Brian Morrow | Physical Therapist | 26555 South Jacob Drive, Channahon, IL 60410 | 2007-05-02 |
| 1356567531 | Alvaro Pedraza | Family Medicine | 25220 W. Reed St., Channahon, IL 60410 | 2007-04-17 |
| 1548338320 | Kevin Breen | Dentist | 25206 W Reed St, Channahon, IL 60410 | 2006-12-01 |
| 1194811943 | Gustavo A Pedraza | Internal Medicine | 25220 W Reed St, Channahon, IL 60410 | 2006-10-05 |
| 1275648511 | Morris Hospital | Clinic/Center | 25259 S Reed St, Channahon, IL 60410 | 2006-08-19 |
| 1184686909 | Nuzhat Chalisa | Internal Medicine | 25259 Reed Street, Channahon, IL 60410 | 2006-04-05 |
| 1558594580 | Paula Susan Fillak | Dentist | 25214 W Reed St, Channahon, IL 60410 | 2009-08-25 |
| 1801823059 | Anna Piper | Emergency Medicine | 27240 W Saxony Dr, Channahon, IL 60410 | 2006-06-26 |
| Find all providers in zip 60410 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720370141 | Christine A Sparks | Developmental Therapist | 26553 W Stonebriar Way, Channahon, IL 60410-8744 | 2011-05-03 |
| 1497903132 | Michelle Keeton | Developmental Therapist | 25833 S Yellow Pine Dr, Channahon, IL 60410-8829 | 2008-09-07 |
| 1376763763 | Anne Marie Stole | Developmental Therapist | 26926 W Hemlock Rd, Channahon, IL 60410-3391 | 2007-04-26 |
| 1598985913 | Kimberly Reif | Developmental Therapist | 26926 W Hemlock Rd, Channahon, IL 60410-3391 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003413568 | Amy Rohan | Developmental Therapist | 17545 Mulberry Ave, Tinley Park, IL 60487-6163 | 2020-10-07 |
| 1992302954 | Vannetta C Thompson | Developmental Therapist | 2247 Gunderson Ave Apt 2, Berwyn, IL 60402-5147 | 2020-10-02 |
| 1477150506 | Quanita Crawford | Developmental Therapist | 3734 W Cortland St Apt 303, Chicago, IL 60647-7565 | 2020-10-01 |
| 1740897412 | Angela Perry | Developmental Therapist | 521 Eden Park Dr, Rantoul, IL 61866-1507 | 2020-09-28 |
| 1235746975 | Dominique Scott | Developmental Therapist | 5342 S Wells St, Chicago, IL 60609-6219 | 2020-09-27 |
| 1003429820 | Adrienne C Latronica | Developmental Therapist | 9865 Cordoba Ct Apt 2b, Orland Park, IL 60462-3190 | 2020-08-31 |
| 1669083424 | Lindsay Miner | Developmental Therapist | 2272 W Leland Ave # 1e, Chicago, IL 60625-2006 | 2020-08-13 |
| 1851901672 | Gretchen Susanne Biggerstaff | Developmental Therapist | 1706 S Hancock St, Mc Leansboro, IL 62859-1996 | 2020-08-06 |
| 1205446549 | Rene Yvonne Green | Developmental Therapist | 14425 E Blue Ridge Dr, Effingham, IL 62401-7168 | 2020-08-02 |
| 1306455357 | Noel Elizabeth Ryall | Developmental Therapist | 9123 Baldwin Dr, Machesney Park, IL 61115-1715 | 2020-07-27 |
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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.