Provider Demographics
NPI:1275798506
Name:SZABLA, MARIA (DT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SZABLA
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 N PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2202
Mailing Address - Country:US
Mailing Address - Phone:184-755-0165
Mailing Address - Fax:
Practice Address - Street 1:64 N PLEASANT RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2202
Practice Address - Country:US
Practice Address - Phone:184-755-0165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILMS61850700P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist