Provider Demographics
NPI:1851594352
Name:CAGE, TANZIE
Entity Type:Individual
Prefix:
First Name:TANZIE
Middle Name:
Last Name:CAGE
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 1:1330 WISCONSIN AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-1253
Mailing Address - Country:US
Mailing Address - Phone:708-494-0067
Mailing Address - Fax:
Practice Address - Street 1:287 CLARIDGE CIR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-6184
Practice Address - Country:US
Practice Address - Phone:630-759-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist