Provider Demographics
NPI:1518140888
Name:CATAPANG, GERARD A (PT,DPT)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:A
Last Name:CATAPANG
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:DR
Other - First Name:GERRY
Other - Middle Name:P
Other - Last Name:CATAPANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:600 OAKMONT LN
Mailing Address - Street 2:STE 600C
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6250
Mailing Address - Fax:630-575-7450
Practice Address - Street 1:1355 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-7641
Practice Address - Country:US
Practice Address - Phone:573-756-9900
Practice Address - Fax:573-756-9988
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA2350Medicare PIN
MO990001804Medicare PIN