Basic Information
| Provider Information | |||||||||
| NPI: | 1376007757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNOZ | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | ANGEL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 N HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605061404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302648440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5035 W PARKER AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606391603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123393276 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2019 | ||||||||
| LastUpdateDate: | 01/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | 096.003857 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.