Provider Demographics
NPI:1427356583
Name:DAYAG, ROSE MARIE TALOSIG (PT)
Entity Type:Individual
Prefix:MISS
First Name:ROSE MARIE
Middle Name:TALOSIG
Last Name:DAYAG
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 1:8909 BELLEFORTE AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2018
Mailing Address - Country:US
Mailing Address - Phone:773-431-7187
Mailing Address - Fax:
Practice Address - Street 1:8596 E 101ST ST
Practice Address - Street 2:STE H
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7037
Practice Address - Country:US
Practice Address - Phone:918-251-5982
Practice Address - Fax:800-856-2020
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018060225100000X
NY031816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist