Organization
CLINICIAN STAFFING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD SAMANIEGO PT (OWNER)
(847) 360-1792
Entity
Organization
Contact information
Practice address
126 W MAPLE AVE, MUNDELEIN, IL 60060-1737
(847) 949-6200
Mailing address
38333 MONARCH CT, BEACH PARK, IL 60087-1566
(847) 360-1792
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070014146
IL
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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