Raquel Festejo Wilde, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013766 Issued in IL

Practice address

Healthpro Heritage
#1 Marcus Drive Ste 102
Greenville, SC 29615

Phone

(864) 244-3626

Fax

(864) 501-4631

NPI assigned

Apr 22, 2008

Last updated

Feb 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Raquel Plamenco Festejo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1417122367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8059 EAST PRAIRIE ROAD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "224-659-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEALTHPRO HERITAGE",
            "address_2": "#1 MARCUS DRIVE STE 102",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-244-3626",
            "fax_number": "864-501-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "RAQUEL",
        "middle_name": "FESTEJO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAQUEL",
            "last_name": "FESTEJO",
            "middle_name": "PLAMENCO",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Garvin Wiginton IV, DO
• Victoria Wiginton, ACNPC-AG
• Mary Wiklacz, LISW-CP
• Abbygail Caroline Wilbourn, PHARMD
• Friederike Wilday, LPC
• Jean Laurel Wilder, CRNA
• Grace Cathryn Wildgen
• David Wildman, DO
• Saleda Jamaille Wiles, LMT
• Christopher Neil Wiley, MD

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.