Healthcare Provider Details

I. General information

NPI: 1265760409
Provider Name (Legal Business Name): PIMENTEL LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 LAKE GILLILAN WAY
ALGONQUIN IL
60102-4284
US

IV. Provider business mailing address

321 LAKE GILLILAN WAY
ALGONQUIN IL
60102-4284
US

V. Phone/Fax

Practice location:
  • Phone: 630-788-7576
  • Fax:
Mailing address:
  • Phone: 630-788-7576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTER M PIMENTEL
Title or Position: C.E.O
Credential: M.D.
Phone: 630-788-7576