Individual
MR. FEDERICO C DAGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2380 S ELMHURST RD # 100, MT PROSPECT, IL 60056-5805
(847) 786-2014
Mailing address
725 CIMARRON DR, CAROL STREAM, IL 60188-9107
(630) 267-4802
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008628
IL
Other
Enumeration date
11/17/2019
Last updated
11/17/2019
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