Individual
PAUL VINCENT ILAGAN TOLENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 WILLOWMERE DR, SOUTH BARRINGTON, IL 60010-6151
(646) 417-3354
Mailing address
5 WILLOWMERE DR, SOUTH BARRINGTON, IL 60010-6151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010294
IL
Other
Enumeration date
06/30/2010
Last updated
02/21/2015
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