MS. MARILYN DAM RABOLT


Address: 112 Marryat Rd, Trout Valley, IL 60013-2644
Phone: 8474620600

MS. MARILYN DAM RABOLT (NPI# 1326232372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326232372
Entity Type Individual
Full Name MS. MARILYN DAM RABOLT
Credential R.N., M.S.N.
Practice Address 112 Marryat Rd
Trout Valley
IL 60013-2644
Practice Telephone 8474620600
Practice Fax Number 8474620600
Mailing Telephone 8474620600
Mailing Fax Number 8474620600
Enumeration Date 2007-09-04
Last Update Date 2007-09-04
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WP0809X Registered Nurse
Specialization: Psych/Mental Health, Adult
IL Nursing Service Providers

Office Location

Street Address 112 MARRYAT RD
City TROUT VALLEY
State IL
Zip Code 60013-2644

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Taxonomy Information

Taxonomy Code 163WP0809X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health, Adult

Taxonomy Definition

Definition to come...

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Competitor

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City TROUT VALLEY
Zip Code 60013

Improve Information

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Dataset Information

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.

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