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NPI Code Detail

MEDICARE: MR. RAMSES DELATORRE RIVERA PT

MEDICARE: MR. RAMSES DELATORRE RIVERA 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1326274432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAMSES DELATORRE RIVERA PT
Provider Business Mailing Address
First Line : 863 BRIARCLIFF RD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440
Country : US
Telephone Number : 630-771-9944
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BROOKDALE RD
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-2126
Country : US
Telephone Number : 630-416-6565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 07/04/2009

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