Individual
AILEEN M PEREGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 968-4400
Mailing address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 968-4400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070008550
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08932005
BCBS OF IL #
IL
Enumeration date
04/04/2007
Last updated
09/06/2012
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