Provider Demographics
NPI:1356467948
Name:ATHAPPILLY, GEO (BLIND REHAB SPECIAL)
Entity Type:Individual
Prefix:
First Name:GEO
Middle Name:
Last Name:ATHAPPILLY
Suffix:
Gender:M
Credentials:BLIND REHAB SPECIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 S WOLF RD
Mailing Address - Street 2:APT 208
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2164
Mailing Address - Country:US
Mailing Address - Phone:269-998-7730
Mailing Address - Fax:
Practice Address - Street 1:5TH ST AND ROOSEVELT
Practice Address - Street 2:BLDG 113
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind