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Contact Information

JACQUELYN M ROGGENBUCK, OTR
324 ROXBURY ROAD
ROCKFORD, IL61107
 Phone: 815-398-9491
 Fax: 815-381-7498
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JACQUELYN M ROGGENBUCK · (Female)

NPI Number 1063625820
Status Active
Credentials OTR (Registered Occupational Therapist)
Entity Individual
Enumeration date 05/08/2007
Last updated 09/13/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 056-011026
  • WI Medicaid 41046100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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