Provider Demographics
NPI:1356433924
Name:SKROCH, VALERIE J (PT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:SKROCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14205 S LONGVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-6008
Mailing Address - Country:US
Mailing Address - Phone:815-293-0931
Mailing Address - Fax:
Practice Address - Street 1:14205 S LONGVIEW LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-6008
Practice Address - Country:US
Practice Address - Phone:815-293-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist