Healthcare Provider Details

I. General information

NPI: 1760318984
Provider Name (Legal Business Name): LAUREANO ENRIQUE ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E GOLF RD
SCHAUMBURG IL
60173-4510
US

IV. Provider business mailing address

3000 SHAMROCK CIR
ELGIN IL
60124-4500
US

V. Phone/Fax

Practice location:
  • Phone: 224-273-6554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: