Provider Demographics
NPI:1306376959
Name:MONTESCO, KLARIZZ BAJAR (PT)
Entity Type:Individual
Prefix:
First Name:KLARIZZ
Middle Name:BAJAR
Last Name:MONTESCO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KLARIZZ
Other - Middle Name:DE LA PLAZA
Other - Last Name:BAJAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 S NAPERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5423
Mailing Address - Country:US
Mailing Address - Phone:630-221-0200
Mailing Address - Fax:630-384-2644
Practice Address - Street 1:3115 N WILKE RD STE A&B
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1400
Practice Address - Country:US
Practice Address - Phone:224-795-5700
Practice Address - Fax:224-795-5705
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070022917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist