Healthcare Provider Details

I. General information

NPI: 1831299791
Provider Name (Legal Business Name): IMELDA MCGETTIGAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2869 N LINCOLN AVE
CHICAGO IL
60657-4201
US

IV. Provider business mailing address

2869 N LINCOLN AVE
CHICAGO IL
60657-4201
US

V. Phone/Fax

Practice location:
  • Phone: 773-665-9950
  • Fax: 773-665-9947
Mailing address:
  • Phone: 773-665-9950
  • Fax: 773-665-9947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: