Individual
ALYSSA PANGANIBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1775 BALLARD RD FL 2, PARK RIDGE, IL 60068-1005
(847) 318-6020
(847) 318-2341
Mailing address
1775 BALLARD RD FL 2, PARK RIDGE, IL 60068-1005
(847) 318-6020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125084419
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2023
Last updated
06/13/2024
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