Provider Demographics
NPI:1730217803
Name:JUMAPAO, DANIEL PREAGIDO (RN, RSA,)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PREAGIDO
Last Name:JUMAPAO
Suffix:
Gender:M
Credentials:RN, RSA,
Other - Prefix:
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Mailing Address - Street 1:1364 NEWCASTLE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-8928
Mailing Address - Country:US
Mailing Address - Phone:630-241-1933
Mailing Address - Fax:630-241-1957
Practice Address - Street 1:6330 BELMONT RD
Practice Address - Street 2:UNIT #5
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-2106
Practice Address - Country:US
Practice Address - Phone:630-241-1933
Practice Address - Fax:630-241-1957
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist