Provider Demographics
NPI:1841416880
Name:GATTAS, PHILLIP A (DC)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:A
Last Name:GATTAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2400
Mailing Address - Country:US
Mailing Address - Phone:773-229-9600
Mailing Address - Fax:773-229-9611
Practice Address - Street 1:6524 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638
Practice Address - Country:US
Practice Address - Phone:773-229-9600
Practice Address - Fax:773-229-9611
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-006349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor