Basic Information
| Provider Information | |||||||||
| NPI: | 1508361148 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SOLORZANO | ||||||||
| FirstName: | HUGO | ||||||||
| MiddleName: | ALEKSANDER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | WATSEKA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 609701484 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 WARRINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 618325446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2174460660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2018 | ||||||||
| LastUpdateDate: | 03/26/2018 | ||||||||
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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 | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.