Provider Demographics
NPI:1558498600
Name:TAEGER, MARCIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:
Last Name:TAEGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARCIA
Other - Middle Name:J
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:402 10TH ST SE
Practice Address - Street 2:SUITE 700
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2435
Practice Address - Country:US
Practice Address - Phone:319-365-9439
Practice Address - Fax:319-365-9368
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist