Provider Demographics
NPI:1932373859
Name:DEL ROSARIO, LADONNA I (PT, DPT)
Entity type:Individual
Prefix:
First Name:LADONNA
Middle Name:I
Last Name:DEL ROSARIO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7122 HALDIR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8814
Mailing Address - Country:US
Mailing Address - Phone:847-219-6197
Mailing Address - Fax:
Practice Address - Street 1:1020 S BOULDER HWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8533
Practice Address - Country:US
Practice Address - Phone:702-856-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILBCBS OF ILOther1619980
ILR03221Medicare PIN
IL568080Medicare PIN
IL567700Medicare PIN
ILR03222Medicare PIN
ILBCBS OF ILOther1619980
IL568150Medicare PIN