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General NPI Number Information
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NPI Number | 1174807465
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Entity Type | Individual
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Provider Name | ALBERTO SEGURA JR. PT
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Gender | Male
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 3501 S HARLEM AVE
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City | BERWYN
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State | IL
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Zip | 60402-3263
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Country | US
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Telephone | 847-818-0461
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Fax | 847-818-0462
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Provider Business Mailing Address
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Address Line | 307 5TH AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10016-6575
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Country | US
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Telephone | 646-518-5562
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Fax | 212-379-2123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 046157
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070-018786
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License Number State | IL
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