Marie Grace Jimenez Dangalan, CPed, CFo, CTO
Pedorthist in Chicago, IL. Individual provider (NPI-1).
NPI number1104722305
StatusActive
Last updated in NPPESOct 15, 2026
Details
- NPI
- 1104722305
- Entity type
- Individual (NPI-1)
- Name
- Marie Grace Jimenez Dangalan
- Credential
- CPed, CFo, CTO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 15, 2026
- Certification date
- Oct 15, 2026
- Last updated
- Oct 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224L00000X | Pedorthist | CPed4548 | IL | Yes |
| 225000000X | Orthotic Fitter | CFo04547 | IL |
Practice location
820 S Damen AveChicago, IL 60612-3728
Phone 224-713-6485
Mailing address
820 S. Damen AvenueOgden Building 3rd Floor
Chicago, IL 60612
Phone 224-713-6485
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