Provider Demographics
NPI:1093793754
Name:CENIZA, ROMEO OCANA JR (PT)
Entity Type:Individual
Prefix:MR
First Name:ROMEO
Middle Name:OCANA
Last Name:CENIZA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:638 DOVER DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-7611
Mailing Address - Country:US
Mailing Address - Phone:630-667-4746
Mailing Address - Fax:
Practice Address - Street 1:160 BIESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3657
Practice Address - Country:US
Practice Address - Phone:847-285-4210
Practice Address - Fax:847-437-1287
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK15317Medicare ID - Type Unspecified