Provider Demographics
NPI:1114294717
Name:TAGUINOD, ERIC ANTHONY PALATAN
Entity Type:Individual
Prefix:MR
First Name:ERIC ANTHONY
Middle Name:PALATAN
Last Name:TAGUINOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4027
Mailing Address - Country:US
Mailing Address - Phone:847-730-9454
Mailing Address - Fax:847-378-8214
Practice Address - Street 1:730 W HINTZ RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5501
Practice Address - Country:US
Practice Address - Phone:847-520-1783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist