Provider Demographics
NPI:1053341883
Name:RAGO, JANE CANDACE (CFO)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:CANDACE
Last Name:RAGO
Suffix:
Gender:F
Credentials:CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 KENYON DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-1229
Mailing Address - Country:US
Mailing Address - Phone:217-528-7541
Mailing Address - Fax:217-522-3118
Practice Address - Street 1:800 N. 1ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702
Practice Address - Country:US
Practice Address - Phone:217-528-7541
Practice Address - Fax:217-522-3118
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCFO02374225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter