Provider Demographics
NPI:1790486934
Name:CALAMARI, TERRA MICHELLE
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:MICHELLE
Last Name:CALAMARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 N CHRISTIANA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5403
Mailing Address - Country:US
Mailing Address - Phone:847-744-0702
Mailing Address - Fax:
Practice Address - Street 1:4521 N CHRISTIANA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5403
Practice Address - Country:US
Practice Address - Phone:847-744-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty