Provider Demographics
NPI:1356626105
Name:ROMERO-BARBUCO, JASMIN GAY PABLO (PT)
Entity Type:Individual
Prefix:MRS
First Name:JASMIN GAY
Middle Name:PABLO
Last Name:ROMERO-BARBUCO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15414 STRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6731
Mailing Address - Country:US
Mailing Address - Phone:773-754-9983
Mailing Address - Fax:
Practice Address - Street 1:7850 W COLLEGE DR
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1010
Practice Address - Country:US
Practice Address - Phone:708-361-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018930225100000X
WAPT 60157230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist