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NPI 1942464664

NPI 1942464664 : PAMELA GILL PT : JUSTICE, IL

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General NPI Number Information
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    NPI Number           |    1942464664
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    Entity Type          |    Individual 
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    Provider Name        |    PAMELA GILL PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/11/2008
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    Last Update Date     |    07/11/2008
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Provider Practice Location Address
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    Address Line         |    9050 W 81ST ST 
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    City                 |    JUSTICE
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    State                |    IL
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    Zip                  |    60458-1350
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    Country              |    US
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    Telephone            |    708-496-7744
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    Fax                  |    708-496-3382
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Provider Business Mailing Address
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    Address Line         |    11143 EAST RD 
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    City                 |    PALOS HILLS
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    State                |    IL
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    Zip                  |    60465-2146
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    Country              |    US
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    Telephone            |    708-974-0058
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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       |    070002834
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    License Number State |    IL
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