Jorge Mauricio Trejo, PTA
Individual provider Active NPI Physical Therapy Assistant · Genoa, IL
NPI 1861180283 · NPPES record last updated Apr 25, 2023
Key facts
- NPI
- 1861180283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160009808 (IL)
- Practice address
- 599 Pearson Dr
Genoa, IL 60135-1383 - Phone
- (630) 933-1500
- NPI assigned
- Apr 25, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 160009808 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160009808 | IL | Yes |
Addresses
Primary practice location
599 Pearson Dr
Genoa, IL 60135-1383
Mailing address
221 S Oak St
Cortland, IL 60112-4080
Phone (815) 981-2996
Other practice location 1
895 S State St
Hampshire, IL 60140-9600
Phone (630) 933-1500
Other providers in Genoa, IL
- Jean Michelle Reiss
- Nan Elaine Ryan
- Shree Verai Aa Medventure Inc
- Bethany L Skowronski
- Steven J. Disanti D.O. S.C.
- Karen Sue Trost
- Christine L. Valentine
All providers in Genoa, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2023. 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.