Healthcare Provider Details
I. General information
NPI: 1215851365
Provider Name (Legal Business Name): GABRIELA LINNEA MINARD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 W 94TH ST
EVERGREEN PARK IL
60805-2818
US
IV. Provider business mailing address
2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US
V. Phone/Fax
- Phone: 773-233-9570
- Fax: 773-233-9607
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 070029909 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: