Provider Demographics
NPI:1891718292
Name:ORETA, LIEZL G (LPT)
Entity Type:Individual
Prefix:
First Name:LIEZL
Middle Name:G
Last Name:ORETA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E IRVING PARK RD
Mailing Address - Street 2:STE. #107
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-2048
Mailing Address - Country:US
Mailing Address - Phone:630-439-0009
Mailing Address - Fax:630-439-0011
Practice Address - Street 1:1279 S NAPER BLVD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8312
Practice Address - Country:US
Practice Address - Phone:630-548-3900
Practice Address - Fax:630-548-3905
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist