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Individual

DENNIS BAGANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2534 E LINCOLN HWY, NEW LENOX, IL 60451-9712
(815) 462-9420
(815) 462-9421
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
(517) 435-3670

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3640571036046701
IL
Enumeration date
08/25/2006
Last updated
10/27/2023
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