| Doctor Name: | DR. EVARISTO PERALTA AGUINALDO |
| NPI Number: | 1861758278 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | 036-056945 |
| Business Practice Address: | 16300 Illinois 53 Crest Hill, IL - 60403 |
| Business Phone Number: | 8157273607 |
| Business Fax Number: | |
| Mailing Address: | 29 Deer Path Trl, BURR RIDGE |
| State: | IL |
| Postal Code: | 605276323 |
| Phone Number: | 6306553052 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2012 |
| NPI Last Update Date: | 04/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036-056945 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |