Healthcare Provider Details

I. General information

NPI: 1053225243
Provider Name (Legal Business Name): VALERIA GUADALUPE CERVANTES LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 S HIGHLAND AVE STE 260
LOMBARD IL
60148-6129
US

IV. Provider business mailing address

1910 S HIGHLAND AVE STE 260
LOMBARD IL
60148-6129
US

V. Phone/Fax

Practice location:
  • Phone: 630-776-3043
  • Fax: 630-929-1390
Mailing address:
  • Phone: 630-776-3043
  • Fax: 630-929-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227024642
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: