GWEN ELIZABETH MEDRANO (NPI# 1205357902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205357902 |
| Entity Type | Individual |
| Full Name | GWEN ELIZABETH MEDRANO |
| Practice Address |
12211 S 44th Pl Alsip IL 60803-2402 |
| Practice Telephone | 7088190443 |
| Mailing Telephone | 7088190443 |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2017-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
12211 S 44TH PL |
| City | ALSIP |
| State | IL |
| Zip Code | 60803-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699173013 | American Medical Lab, Ltd | Clinical Medical Laboratory | 5130 W 125th Pl, American Medical Lab, Alsip, IL 60803 | 2014-12-17 |
| 1225387574 | A Touch of Class Dentistry II | Dentist | 12033 S. Pulaski Road, Alsip, IL 60803 | 2012-08-31 |
| 1841431657 | George P. Danos Inc | Dentist | 5101 W 111th St, Alsip, IL 60803 | 2009-03-09 |
| 1194898114 | Vital Rehabilitation & Physical Therapy Inc | Clinic/Center | 11600 S Kedzie, Merrionette Park, IL 60803 | 2006-11-16 |
| 1841203650 | Alsip Dental Arts PC | Dentist | 11107 South Lawler, Alsip, IL 60803 | 2006-08-14 |
| 1477500932 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 12001 S Pulaski Rd, Alsip, IL 60803 | 2006-05-30 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 1467064360 | Yash Desai | Pharmacist | 12290 S Pulaski Rd, Alsip, IL 60803 | 2020-08-20 |
| 1609293539 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3243 W 115th St, Merrionette Park, IL 60803 | 2014-03-28 |
| 1114357092 | Abdul Hussein Darki | Pediatrics | 11808 S Pulaski Rd, Alsip, IL 60803 | 2013-11-14 |
| Find all providers in zip 60803 | ||||
| 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 |
|---|---|---|---|---|
| 1023458932 | Tanya T Brown | Developmental Therapist | 4125 W 127th St, Apt. 4w, Alsip, IL 60803-4010 | 2013-06-25 |
| 1124324470 | Genesis Saele | Developmental Therapist | 12036 S Kildare Ave, Alsip, IL 60803-2306 | 2011-02-03 |
| 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 |
| 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.