Basic Information
| Provider Information | |||||||||
| NPI: | 1982755260 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUZANO | ||||||||
| FirstName: | CRISPINO | ||||||||
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| NameSuffix: | JR. | ||||||||
| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 NEWPORT DR | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | ROLLING MEADOWS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600083832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8477971050 | ||||||||
| FaxNumber: | 8477971337 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 W GOLF RD | ||||||||
| Address2: | |||||||||
| City: | LIBERTYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600483213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473679924 | ||||||||
| FaxNumber: | 8473678093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2007 | ||||||||
| LastUpdateDate: | 09/10/2007 | ||||||||
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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 | 225100000X | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.