Individual
AMANDA AREVALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MS, PCS
Contact information
Practice address
6915 30TH PL, BERWYN, IL 60402-2957
(708) 602-1581
(708) 484-8841
Mailing address
6915 30TH PL, BERWYN, IL 60402-2957
(708) 602-1581
(708) 484-8841
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634441
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/16/2007
Last updated
07/08/2007
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