MEDICARE: JUDY CORPUZ DEL MUNDO LMT

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	225700000X	Massage Therapist	227012886	IL

General Provider Information

NPI Number	:	1285033910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY CORPUZ DEL MUNDO LMT

Provider Business Mailing Address
First Line	:	2634 COLLEGE HILL CIR
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60173-5753
Country	:	US
Telephone Number	:	847-800-5166
Fax Number	:

Provider Business Practice Location Address
First Line	:	2168 PLUM GROVE RD
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1932
Country	:	US
Telephone Number	:	847-963-4894
Fax Number	:

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	01/10/2019

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