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Individual

CRISTINA LACSINA CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, CKTP

Contact information

Practice address
1366 W. FULLERTON AVE.,, CHICAGO, IL 60614
(773) 248-9300
Mailing address
5432 N. LYNCH AVE., CHICAGO, IL 60630
(773) 853-0434

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015235
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070015235
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
02/08/2012
Last updated
02/08/2012
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