MEDICARE: MR. MARK ANTHONY LAGO 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
1	225100000X	Physical Therapist	070.019839	IL

General Provider Information

NPI Number	:	1730511460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK ANTHONY LAGO PT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 W MONEE MANHATTAN RD STE 115
Second Line	:
City	:	MONEE
State	:	IL
Zip	:	60449-8866
Country	:	US
Telephone Number	:	708-314-7761
Fax Number	:

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

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	06/04/2025

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Directions to “ MR. MARK ANTHONY LAGO PT” Practice Location

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