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NPI Code Detail

MEDICARE: MRS. ERMINA ANG DOROIN PT

MEDICARE: MRS. ERMINA ANG DOROIN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251G0304XGeriatric Physical Therapist070015178IL

General Provider Information

NPI Number : 1013157403
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERMINA ANG DOROIN PT
Provider Business Mailing Address
First Line : 10608 S DEPOT ST
Second Line : 2B
City : WORTH
State : IL
Zip : 60482-1244
Country : US
Telephone Number : 708-415-8379
Fax Number :
Provider Business Practice Location Address
First Line : 2649 E 75TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60649-3835
Country : US
Telephone Number : 773-338-2811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2009
Last Update Date : 04/10/2010

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