Bermundo, Cicero Offemaria

Bermundo, Cicero Offemaria is an individual health care provider with primary practice located at 620 Warrington Ave , Danville IL 61832-5446. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant is his primary health care specialty. Bermundo, Cicero Offemaria can be contacted via phone (217) 446-0660.

Contact Information

Primary practice address
620 Warrington Ave Danville IL 61832-5446
Phone: (217) 446-0660
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 043112534 Illinois
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 160.007924 Illinois

Profile Details

NPI number 1720588304
LBN Legal business name Bermundo, Cicero Offemaria
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2018
Last updated Feb 20th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720588304 NPPES
Illinois MEDICAID 145183

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