Provider Demographics
NPI:1851788228
Name:GALVEZ, ROSENDO (LMT)
Entity Type:Individual
Prefix:MR
First Name:ROSENDO
Middle Name:
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9019 HILLCREST LN
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-7553
Mailing Address - Country:US
Mailing Address - Phone:630-544-7300
Mailing Address - Fax:
Practice Address - Street 1:9019 HILLCREST LN
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-7553
Practice Address - Country:US
Practice Address - Phone:630-544-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.013993225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist