Provider Demographics
NPI:1518001171
Name:SEGURA, JULIANNA GAL (FT MS)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNA
Middle Name:GAL
Last Name:SEGURA
Suffix:
Gender:F
Credentials:FT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 N DEARBORN ST
Mailing Address - Street 2:SUITE 1410N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610
Mailing Address - Country:US
Mailing Address - Phone:312-642-8519
Mailing Address - Fax:
Practice Address - Street 1:1221 N DEARBORN ST
Practice Address - Street 2:SUITE 1410N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610
Practice Address - Country:US
Practice Address - Phone:312-642-8519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC1621229OtherBLUE CROSS