Provider Demographics
NPI:1497936728
Name:GAGER, RAYMOND CLAUDIOUS II (PT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:CLAUDIOUS
Last Name:GAGER
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 SILHAVY RD STE 121
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4491
Practice Address - Country:US
Practice Address - Phone:219-462-0576
Practice Address - Fax:219-462-0216
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19309225100000X
IN05009597A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist