Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 036.140118 | IL |
NPI | 1023459088 |
---|---|
Provider Name | Dr. Henry Mallillin Legaspi |
First Address | Elmhurst, IL 60126-5628 |
Second Address | Elmhurst, IL 60126-5628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2013 |
Last Update Date | 06/04/2021 |