Provider Demographics
NPI:1417231663
Name:PAPAK, CORRINE MARIE
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:MARIE
Last Name:PAPAK
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 1:1 GOLFVIEW RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1210
Mailing Address - Country:US
Mailing Address - Phone:224-639-3246
Mailing Address - Fax:
Practice Address - Street 1:1 GOLFVIEW RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-1210
Practice Address - Country:US
Practice Address - Phone:224-639-3246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL539875-07225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist