Provider Demographics
NPI:1457519258
Name:BARQUIN, WILL K
Entity Type:Individual
Prefix:
First Name:WILL
Middle Name:K
Last Name:BARQUIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WILFREDO
Other - Middle Name:K
Other - Last Name:BARQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:751 S MONTCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-5422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:751 S MONTCLAIR DR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-5422
Practice Address - Country:US
Practice Address - Phone:847-740-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist