Provider Demographics
NPI:1962908657
Name:JACOBO ARROYO, DIANA JAZMIN
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:JAZMIN
Last Name:JACOBO ARROYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2930
Mailing Address - Country:US
Mailing Address - Phone:630-400-9451
Mailing Address - Fax:
Practice Address - Street 1:1038 AUGUSTA AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2930
Practice Address - Country:US
Practice Address - Phone:630-400-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer