Provider Demographics
NPI:1467902627
Name:ZARAGOZA, FRITZ (PT)
Entity Type:Individual
Prefix:
First Name:FRITZ
Middle Name:
Last Name:ZARAGOZA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 FOXRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-3280
Mailing Address - Country:US
Mailing Address - Phone:660-553-7761
Mailing Address - Fax:
Practice Address - Street 1:3214 FOXRIDGE CT
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-3280
Practice Address - Country:US
Practice Address - Phone:660-553-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.016429225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist