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General NPI Number Information
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NPI Number | 1629126859
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Entity Type | Individual
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Provider Name | ANA LIZA MALIGAYA RPT
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2804 75TH ST
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City | WOODRIDGE
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State | IL
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Zip | 60517-2850
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Country | US
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Telephone | 630-963-9200
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Fax | 630-963-9275
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Provider Business Mailing Address
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Address Line | 1519 SHAGBARK DR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-6582
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Country | US
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Telephone | 630-226-0806
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Fax |
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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 |
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License Number State | IL
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