Provider Demographics
NPI:1942558937
Name:TABILON, AIMEE AURELIO (PT)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:AURELIO
Last Name:TABILON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:CARMONA
Other - Last Name:AURELIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16089 POPPYSEED CIR UNIT 2008
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6314
Mailing Address - Country:US
Mailing Address - Phone:561-496-7993
Mailing Address - Fax:561-496-0589
Practice Address - Street 1:3647 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5527
Practice Address - Country:US
Practice Address - Phone:224-244-0512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist