Provider Demographics
NPI:1184988735
Name:MOTIVATE HEALTH INC
Entity type:Organization
Organization Name:MOTIVATE HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:815-637-1100
Mailing Address - Street 1:6280 CHEROKEE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61109-4499
Mailing Address - Country:US
Mailing Address - Phone:815-874-2192
Mailing Address - Fax:
Practice Address - Street 1:3057 N PERRYVILLE RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8016
Practice Address - Country:US
Practice Address - Phone:630-965-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy