Jose Raul Aguirre
Individual provider Active NPI Massage Therapist · Berwyn, IL
NPI 1003577784 · NPPES record last updated Jan 5, 2022
Key facts
- NPI
- 1003577784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227.019052 (IL)
- Practice address
- 2627 Euclid Ave
Berwyn, IL 60402-2519 - Phone
- (872) 333-4356
- NPI assigned
- Jan 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.019052 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.019052 | IL | Yes |
Addresses
Primary practice location
2627 Euclid Ave
Berwyn, IL 60402-2519
Mailing address
2627 Euclid Ave
Berwyn, IL 60402-2519
Phone (872) 333-4356
Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.