Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 226300000X | Kinesiotherapist | 1492 | IL |
NPI | 1538131180 |
---|---|
Provider Name | Mr. Philip Chiaramonte |
First Address | Clarendon Hills, IL 60514-1691 |
Second Address | Clarendon Hills, IL 60514-1691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1492 | KINESIPTHERAPIST (01) | IL |