Individual
IRVING BALLENA ROSAUPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
675 S ROSELLE RD, SCHAUMBURG, IL 60193-3100
(847) 352-5500
Mailing address
675 S ROSELLE RD, SCHAUMBURG, IL 60193-3100
(847) 352-5500
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056007816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056007816
ILLINOIS OCCUPATIONAL THERAPY LICENSE
IL
Enumeration date
11/28/2011
Last updated
11/28/2011
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