Provider Demographics
NPI:1689897407
Name:GAMALSKI, LYNETTE E (DT)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:E
Last Name:GAMALSKI
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1N401 SHADE TREE LN
Mailing Address - Street 2:
Mailing Address - City:MAPLE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60151-8023
Mailing Address - Country:US
Mailing Address - Phone:630-365-3236
Mailing Address - Fax:630-365-3237
Practice Address - Street 1:1N401 SHADE TREE LN
Practice Address - Street 2:
Practice Address - City:MAPLE PARK
Practice Address - State:IL
Practice Address - Zip Code:60151-8023
Practice Address - Country:US
Practice Address - Phone:630-365-3236
Practice Address - Fax:630-365-3237
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist