Individual
MR. IGNACIO CHAN TALOSIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
19600 LA GRANGE RD, MOKENA, IL 60448-9321
(708) 478-3000
(708) 478-3007
Mailing address
13656 LAMON AVE, CRESTWOOD, IL 60445-1833
(708) 371-3546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-014184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-014184
STATE LICENSE
IL
Enumeration date
02/08/2007
Last updated
06/17/2008
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