Provider Demographics
NPI:1053655282
Name:PILARIO, JONATHAN VERANO (RPT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:VERANO
Last Name:PILARIO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 CRIMSON DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-1127
Mailing Address - Country:US
Mailing Address - Phone:847-414-7460
Mailing Address - Fax:
Practice Address - Street 1:1811 CRIMSON DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-1127
Practice Address - Country:US
Practice Address - Phone:847-414-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007919A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist