Healthcare Provider Details

I. General information

NPI: 1740121946
Provider Name (Legal Business Name): SALVADOR OREGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BARNEY DR
JOLIET IL
60435-5296
US

IV. Provider business mailing address

605 N HICKORY ST
JOLIET IL
60435-6322
US

V. Phone/Fax

Practice location:
  • Phone: 708-374-5558
  • Fax:
Mailing address:
  • Phone: 708-374-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-494142
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: