Provider Demographics
NPI:1679912489
Name:ADAMS, NORA S (LMT, NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:NORA
Middle Name:S
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36W659 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4817
Mailing Address - Country:US
Mailing Address - Phone:847-494-7372
Mailing Address - Fax:
Practice Address - Street 1:36W659 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4817
Practice Address - Country:US
Practice Address - Phone:847-494-7372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-18513225700000X
IL227005300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist