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Individual

ASHLEY CERULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
12261 W 159TH ST, HOMER GLEN, IL 60491-7847
(708) 301-2255
Mailing address
12261 W 159TH ST, HOMER GLEN, IL 60491-7847
(708) 301-2255

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01190975
MEDICARE RR
IL
01
P01285698
MEDICARE RAILROAD
IL
Enumeration date
07/11/2012
Last updated
12/10/2019
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