| Doctor Name: | JIMMY DAPOG |
| NPI Number: | 1164780185 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 070007758 |
| Business Practice Address: | 628 Illinois St Litchfield, IL - 62056 |
| Business Phone Number: | 2173242153 |
| Business Fax Number: | |
| Mailing Address: | 819 N Van Buren St, LITCHFIELD |
| State: | IL |
| Postal Code: | 620561552 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2012 |
| NPI Last Update Date: | 04/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251G0304X |
| License Number: | 070007758 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Geriatrics |
| Taxonomy Definition: | |