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NPI Code Detail

MEDICARE: GILBERT J CUA PT

MEDICARE: GILBERT J CUA PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070007910IL
2225100000XPhysical Therapist070-007910IL

General Provider Information

NPI Number : 1336193507
Entity Type Code : Individual
Provider Name (Legal Business Name) : GILBERT J CUA PT
Provider Business Mailing Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Provider Business Practice Location Address
First Line : 2000 LAKE AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-7401
Country : US
Telephone Number : 815-337-7100
Fax Number : 815-337-4793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 10/07/2014

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Directions to “ GILBERT J CUA PT” Practice Location

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