Provider Demographics
NPI:1265479083
Name:ALAYU-NICHOLS, MACRINA LUMICAO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MACRINA
Middle Name:LUMICAO
Last Name:ALAYU-NICHOLS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 EVERS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-3411
Mailing Address - Country:US
Mailing Address - Phone:708-562-3524
Mailing Address - Fax:
Practice Address - Street 1:1236 EVERS AVE
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-3411
Practice Address - Country:US
Practice Address - Phone:708-562-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-00002915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist