MEDICARE: MS. DONNA B REGALADO P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	870153	DC
2	225100000X	Physical Therapist	18306	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	46950046	OTHER		CAREFIRST NCA
2	890199-04	OTHER		CAREFIRST OF MARYLAND

General Provider Information

NPI Number	:	1164427720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA B REGALADO P.T.

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3018 FESTIVAL WAY
Second Line	:	#323
City	:	WALDORF
State	:	MD
Zip	:	20601-2958
Country	:	US
Telephone Number	:	240-754-5520
Fax Number	:	301-705-6797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	04/17/2025

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