Provider Demographics
NPI:1366121899
Name:NUNEZ, FAVIO (DPT)
Entity type:Individual
Prefix:
First Name:FAVIO
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 OTIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60436-2505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42 S WEBER RD.
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-4947
Practice Address - Country:US
Practice Address - Phone:630-856-6479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0269922251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic