Francisco Saucillo

Individual provider Active NPI Physical Therapy Assistant · Broadview, IL

NPI 1124401906 · NPPES record last updated Jun 30, 2015

Key facts

NPI
1124401906
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160006040 (IL)
Practice address
2931 S 10TH Ave
Broadview, IL 60155-4829
Phone
(708) 674-0434
NPI assigned
Jun 30, 2015
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

LicenseStateTypeSpecialty
160006040ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160006040 IL Yes

Addresses

Primary practice location

2931 S 10TH Ave
Broadview, IL 60155-4829

Mailing address

2931 S 10TH Ave
Broadview, IL 60155-4829

Other providers in Broadview, IL

All providers in Broadview, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.