Individual
MR. LEONCIO KING MENGUITO GERONIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT, OTR/L
Contact information
Practice address
2021 RANDI DR, AURORA, IL 60504-4758
(630) 692-0450
Mailing address
2171 W EXECUTIVE DR STE 500, ADDISON, IL 60101-5626
(630) 766-0505
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
012691
IL
225X00000X
Occupational Therapist
Primary
056.12691
IL
Other
Enumeration date
03/16/2019
Last updated
03/16/2019
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