Provider Demographics
NPI:1487867560
Name:GREGORY, LOUISE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5202
Mailing Address - Country:US
Mailing Address - Phone:847-620-4571
Mailing Address - Fax:847-620-4575
Practice Address - Street 1:1301 S BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5202
Practice Address - Country:US
Practice Address - Phone:847-620-4571
Practice Address - Fax:847-620-4575
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist