Provider Demographics
NPI:1699042119
Name:GERONGAY, ABIGAIL JOAN TINGZON (PT)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL JOAN
Middle Name:TINGZON
Last Name:GERONGAY
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 1:5838 N SHERIDAN RD
Mailing Address - Street 2:GENESIS SHERIDAN SHORE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4916
Mailing Address - Country:US
Mailing Address - Phone:407-756-8744
Mailing Address - Fax:
Practice Address - Street 1:5838 N SHERIDAN RD
Practice Address - Street 2:GENESIS SHERIDAN SHORE
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4916
Practice Address - Country:US
Practice Address - Phone:407-756-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist