Provider Demographics
NPI:1295008449
Name:MARROQUIN, ARTHUR MIGUEL (PTA)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:MIGUEL
Last Name:MARROQUIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 N LYLE AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4708
Mailing Address - Country:US
Mailing Address - Phone:630-208-4550
Mailing Address - Fax:
Practice Address - Street 1:780 N LYLE AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4708
Practice Address - Country:US
Practice Address - Phone:630-208-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160004103282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital