Provider Demographics
NPI:1346424959
Name:AYOS, JONAH GILONGOS (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JONAH
Middle Name:GILONGOS
Last Name:AYOS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:JONAH
Other - Middle Name:SEGOVIA
Other - Last Name:GILONGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:5241 JOG LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6652
Mailing Address - Country:US
Mailing Address - Phone:561-715-7460
Mailing Address - Fax:
Practice Address - Street 1:3150 N LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4810
Practice Address - Country:US
Practice Address - Phone:561-715-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist