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General NPI Number Information
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NPI Number | 1942123476
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Entity Type | Individual
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Provider Name | GERARDO ABREGO PTA
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Gender | Male
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Dates
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Enumeration Date | 08/01/2026
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Last Update Date | 08/01/2026
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Provider Practice Location Address
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Address Line | 6187 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2812
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Country | US
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Telephone | 773-500-2620
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Fax | 773-500-2630
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Provider Business Mailing Address
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Address Line | 2711 S RIDGEWAY AVE
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City | CHICAGO
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State | IL
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Zip | 60623-4525
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160020659
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License Number State | IL
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