Provider Demographics
NPI:1699818070
Name:TAYLOR, MARGE LAFLAMME (PT, ATC)
Entity Type:Individual
Prefix:
First Name:MARGE
Middle Name:LAFLAMME
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:LAFLAMME
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, ATC
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:1397 SILVER BLUFF RD STE 100
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-9784
Practice Address - Country:US
Practice Address - Phone:803-220-1073
Practice Address - Fax:803-380-7044
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
MI55013006492251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0279216OtherL & I
WA0279229OtherL & I
WA0279925OtherL &
WA0279127OtherL & I
WAG8901175Medicare PIN
WAG8901173Medicare PIN
WAG8905278Medicare PIN
WA0279925OtherL &
WAG8901174Medicare PIN