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NPI Code Detail

MEDICARE: DON JORGE U PAGUNTALAN P.T.

MEDICARE:   DON JORGE U PAGUNTALAN  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070011656IL

General Provider Information

NPI Number : 1578500419
Entity Type Code : Individual
Provider Name (Legal Business Name) : DON JORGE U PAGUNTALAN P.T.
Provider Business Mailing Address
First Line : 5946 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-5424
Country : US
Telephone Number : 773-775-6637
Fax Number : 773-775-6638
Provider Business Practice Location Address
First Line : 5946 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-5424
Country : US
Telephone Number : 773-775-6637
Fax Number : 773-775-6638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 12/12/2008

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Directions to “ DON JORGE U PAGUNTALAN P.T.” Practice Location

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