Provider Demographics
NPI:1164839049
Name:ARAGON, IDALIZ
Entity Type:Individual
Prefix:
First Name:IDALIZ
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N WOLF RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1750
Mailing Address - Country:US
Mailing Address - Phone:847-296-4539
Mailing Address - Fax:
Practice Address - Street 1:125 N WOLF RD
Practice Address - Street 2:
Practice Address - City:PROSPECT HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60070-1750
Practice Address - Country:US
Practice Address - Phone:847-296-4539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-12
Last Update Date:2014-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter