Organization
AMANDA AREVALO, P.C.
Active
Organization
AMANDA AREVALO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA AREVALO (OWNER)
(708) 602-1581
Entity
Organization
Contact information
Practice address
6915 30TH PL, BERWYN, IL 60402-2957
(708) 602-1581
Mailing address
PO BOX 1651, NORTH RIVERSIDE, IL 60546-0951
(708) 602-1581
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634441
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
03/21/2007
Last updated
08/22/2020
Update your record
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