Individual
MR. ALFONSO ALLAN M BALLEZA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1480 RENAISSANCE DR STE 211, PARK RIDGE, IL 60068-1353
(847) 296-6161
(847) 296-6262
Mailing address
1480 RENAISSANCE DR STE 211, PARK RIDGE, IL 60068-1353
(847) 296-6161
(847) 296-6262
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
041388781
IL
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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