Ronald Frank Agrigento, P.T., A.T.C.

Individual provider Active NPI Physical Therapist · Blue Island, IL

NPI 1376658161 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376658161
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
13114 Western Ave
Blue Island, IL 60406-2439
Phone
(708) 824-0515
Fax
(708) 824-0516
NPI assigned
Aug 20, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
070-005949ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Yes

Addresses

Primary practice location

13114 Western Ave
Blue Island, IL 60406-2439

Mailing address

18465 Cowing CT
Homewood, IL 60430-3334
Phone (708) 206-0584

Other providers in Blue Island, IL

All providers in Blue Island, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.