Provider Demographics
NPI:1073016010
Name:TOVAR, GILBERTO (ATC)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
Last Name:TOVAR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22045 W LAKELAND TRL
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-6012
Mailing Address - Country:US
Mailing Address - Phone:815-557-9835
Mailing Address - Fax:
Practice Address - Street 1:22045 W LAKELAND TRL
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-6012
Practice Address - Country:US
Practice Address - Phone:815-557-9835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer