Healthcare Provider Details

I. General information

NPI: 1801702956
Provider Name (Legal Business Name): JEREMY JON MANLAPAZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 EXECUTIVE DR STE 250
WESTMONT IL
60559-6137
US

IV. Provider business mailing address

437 SPRUCE CT
SCHAUMBURG IL
60193-1528
US

V. Phone/Fax

Practice location:
  • Phone: 630-655-8785
  • Fax:
Mailing address:
  • Phone: 773-992-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number056.027254
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: