Provider Demographics
NPI:1285033910
Name:DEL MUNDO, JUDY CORPUZ (LMT)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:CORPUZ
Last Name:DEL MUNDO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 COLLEGE HILL CIR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5753
Mailing Address - Country:US
Mailing Address - Phone:847-800-5166
Mailing Address - Fax:
Practice Address - Street 1:2168 PLUM GROVE RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1932
Practice Address - Country:US
Practice Address - Phone:847-963-4894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227012886225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist