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General NPI Number Information
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NPI Number | 1700739521
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Entity Type | Individual
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Provider Name | ARMAND BRACERO PTA
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Gender | Male
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 3973 W ALGONQUIN RD
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City | ALGONQUIN
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State | IL
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Zip | 60102-9700
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Country | US
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Telephone | 224-348-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 55 HAMILTON AVE
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City | ELGIN
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State | IL
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Zip | 60123-5305
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160.010611
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License Number State | IL
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