Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Omar Fonseca

Individual provider Physical Therapy Assistant · NPI 1366101420

Omar Fonseca is a Physical Therapy Assistant in Woodstock, Illinois. Licensed in Illinois. Registered with an NPI since 2021.

Licensed in
IL
In the registry since
2021

Practice location Address checks out

2000 Lake Ave
Woodstock, IL 60098-7401
Phone: (815) 206-3388
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160.009394 (IL)

Record details

NPI number1366101420
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 15, 2021
Last updated in NPPESDecember 15, 2021
Certification dateDecember 15, 2021
Mailing address277 Deerpath Dr, Genoa City, WI 53128-2504

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