Healthcare Provider Details

I. General information

NPI: 1558029652
Provider Name (Legal Business Name): SAMUEL GABEL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N STATE ST
CHICAGO IL
60654-3820
US

IV. Provider business mailing address

710 N STATE ST
CHICAGO IL
60654-3820
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-1500
  • Fax: 630-933-1550
Mailing address:
  • Phone: 630-933-1500
  • Fax: 630-933-1550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.025989
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015724
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019396
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: