Provider Demographics
NPI:1073634671
Name:GARSTKA, MARLA JOY
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:JOY
Last Name:GARSTKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 HADDON CIR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-2920
Mailing Address - Country:US
Mailing Address - Phone:847-816-4531
Mailing Address - Fax:
Practice Address - Street 1:1850 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1228
Practice Address - Country:US
Practice Address - Phone:312-666-1331
Practice Address - Fax:312-506-0103
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist