Provider Demographics
NPI:1841800570
Name:LULUQUISIN, DAYZA MALIBIRAN (DPT)
Entity Type:Individual
Prefix:
First Name:DAYZA
Middle Name:MALIBIRAN
Last Name:LULUQUISIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2063 POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7562
Mailing Address - Country:US
Mailing Address - Phone:630-340-0595
Mailing Address - Fax:
Practice Address - Street 1:600 DUNHAM RD
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-7885
Practice Address - Country:US
Practice Address - Phone:630-587-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL070014097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL900327572OtherUNITED HEALTH CARE