Provider Demographics
NPI:1477211597
Name:HARRINGTON, ROSSYVETTE (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:ROSSYVETTE
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 KINGS WAY W
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3257
Mailing Address - Country:US
Mailing Address - Phone:847-749-6884
Mailing Address - Fax:
Practice Address - Street 1:3001 GREEN BAY RD # 11PC
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-1278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-3386792171400000X
226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
No171400000XOther Service ProvidersHealth & Wellness Coach