Provider Demographics
NPI:1760706741
Name:GO, ANN GINA C (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:ANN GINA
Middle Name:C
Last Name:GO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:4351 CAMELOT CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-3190
Mailing Address - Country:US
Mailing Address - Phone:630-839-9393
Mailing Address - Fax:630-839-9393
Practice Address - Street 1:4351 CAMELOT CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-3190
Practice Address - Country:US
Practice Address - Phone:630-839-9393
Practice Address - Fax:630-839-9393
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070-007405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist