Provider Demographics
NPI:1093820805
Name:AGRIGENTO, ROCHELLE ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:ANN
Last Name:AGRIGENTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18465 COWING CT
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3334
Mailing Address - Country:US
Mailing Address - Phone:708-824-0515
Mailing Address - Fax:708-824-0517
Practice Address - Street 1:1816 170TH ST
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1451
Practice Address - Country:US
Practice Address - Phone:708-335-1415
Practice Address - Fax:708-335-4792
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist