Provider Demographics
NPI:1588430888
Name:RAQUENO, ALEXIS TOLEDO (DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:TOLEDO
Last Name:RAQUENO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:NORIEGA
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:165 HARGRAVES DR STE M400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4813
Practice Address - Country:US
Practice Address - Phone:512-975-7773
Practice Address - Fax:512-387-2955
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305184225100000X
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist