Provider Demographics
NPI:1396946612
Name:ARUGUETE, LISA PAULINA (LMT)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:PAULINA
Last Name:ARUGUETE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14310 W WADSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60083-9418
Mailing Address - Country:US
Mailing Address - Phone:847-360-0558
Mailing Address - Fax:847-662-1109
Practice Address - Street 1:2816 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4840
Practice Address - Country:US
Practice Address - Phone:847-662-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist