Individual
JERRY MASANGCAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 FAIRFIELD WAY STE 106B, BLOOMINGDALE, IL 60108-1555
(630) 283-0393
(847) 466-7068
Mailing address
4926 CRAIN ST UNIT C, SKOKIE, IL 60077-5444
(847) 466-7069
(630) 283-0343
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
3001932
IL
376J00000X
Homemaker
Primary
3001932
IL
376J00000X
Homemaker
INH2202079
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3001932
IDPH LICENSE
IL
Enumeration date
10/24/2022
Last updated
10/24/2022
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