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NPI Code Detail

MEDICARE: LOUIS J HILLEGASS III BSPT

MEDICARE: LOUIS J HILLEGASS III BSPT
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 Therapist770NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699712455
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIS J HILLEGASS III BSPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2223
Fax Number :
Provider Business Practice Location Address
First Line : 7301 PEAK DR
Second Line : SUITE 101
City : LAS VEGAS
State : NV
Zip : 89128-9038
Country : US
Telephone Number : 702-940-3000
Fax Number : 702-940-3000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 09/01/2015

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