MEDICARE: SAMUEL GABEL DPT

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	070.025989	IL
2	225100000X	Physical Therapist	PT015724	GA
3	225100000X	Physical Therapist	PT019396	OH

General Provider Information

NPI Number	:	1558029652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL GABEL DPT

Provider Business Mailing Address
First Line	:	710 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3820
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

Provider Business Practice Location Address
First Line	:	710 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3820
Country	:	US
Telephone Number	:	630-933-1500
Fax Number	:	630-933-1550

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

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	01/05/2026

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