Provider Demographics
NPI:1376278903
Name:FELIPE, ROSALINE MELEGRITO (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROSALINE
Middle Name:MELEGRITO
Last Name:FELIPE
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 1:1625 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-5907
Mailing Address - Country:US
Mailing Address - Phone:779-696-8327
Mailing Address - Fax:
Practice Address - Street 1:1625 S STATE ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-5907
Practice Address - Country:US
Practice Address - Phone:779-696-8327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist