Provider Demographics
NPI:1316187370
Name:TOWNSEND, CHEVON
Entity Type:Individual
Prefix:MISS
First Name:CHEVON
Middle Name:
Last Name:TOWNSEND
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 1:3709 TAMARIND LN
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1526
Mailing Address - Country:US
Mailing Address - Phone:708-228-9709
Mailing Address - Fax:708-335-4169
Practice Address - Street 1:3709 TAMARIND LN
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1526
Practice Address - Country:US
Practice Address - Phone:708-228-9709
Practice Address - Fax:708-335-4169
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist