Provider Demographics
NPI:1598081655
Name:ENCARNACION, JOHN PAUL MANLANGIT (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN PAUL
Middle Name:MANLANGIT
Last Name:ENCARNACION
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 1:200 RIVER FRONT DR
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1993
Mailing Address - Country:US
Mailing Address - Phone:224-522-5083
Mailing Address - Fax:
Practice Address - Street 1:200 RIVER FRONT DR
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1993
Practice Address - Country:US
Practice Address - Phone:224-522-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist