Provider Demographics
NPI:1386856052
Name:RICE, STAR (DEVELOPMENTAL)
Entity Type:Individual
Prefix:
First Name:STAR
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:DEVELOPMENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2777
Mailing Address - Country:US
Mailing Address - Phone:630-966-4412
Mailing Address - Fax:630-844-2065
Practice Address - Street 1:309 WEST NEW INDIAN TRAIL COURT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506
Practice Address - Country:US
Practice Address - Phone:630-966-4412
Practice Address - Fax:630-844-2065
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist