MEDICARE: DENICE PARAISO

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
1	225100000X	Physical Therapist	28339	MD
2	225100000X	Physical Therapist		NV

General Provider Information

NPI Number	:	1033786165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENICE PARAISO

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E WINDMILL LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1902
Country	:	US
Telephone Number	:	702-202-1280
Fax Number	:	702-361-8596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	04/03/2025

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Directions to “ DENICE PARAISO ” Practice Location

Language	Start Address	Practice Location

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