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General NPI Number Information
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NPI Number | 1538306535
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Entity Type | Individual
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Provider Name | GAYATRI D MATHUR PT
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Gender | Female
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 755 SKOKIE BLVD
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City | NORTHBROOK
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State | IL
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Zip | 60062-2805
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Country | US
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Telephone | 847-272-7426
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Fax | 847-412-6440
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Provider Business Mailing Address
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Address Line | 43 TURNBULL WOODS CT
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5135
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Country | US
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Telephone | 847-266-9328
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.010463
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License Number State | IL
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