Provider Demographics
NPI:1962812685
Name:RUSHTON, JUDY THERESA
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:THERESA
Last Name:RUSHTON
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 1:1318 SAVANNAH LN
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-9011
Mailing Address - Country:US
Mailing Address - Phone:815-568-5448
Mailing Address - Fax:
Practice Address - Street 1:1318 SAVANNAH LN
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-9011
Practice Address - Country:US
Practice Address - Phone:815-568-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist