Provider Demographics
NPI:1679220925
Name:BARROGO, MARILOU UNTALAN (PT ,DPT)
Entity Type:Individual
Prefix:
First Name:MARILOU
Middle Name:UNTALAN
Last Name:BARROGO
Suffix:
Gender:F
Credentials:PT ,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CAROL ST APT A
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1245
Mailing Address - Country:US
Mailing Address - Phone:773-709-4551
Mailing Address - Fax:
Practice Address - Street 1:1304 CAROL ST APT A
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1245
Practice Address - Country:US
Practice Address - Phone:773-709-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics