Provider Demographics
NPI:1881653020
Name:GAGLIANO, YVONNE (PT)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:GAGLIANO
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 1:2357 HASSELL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2172
Mailing Address - Country:US
Mailing Address - Phone:847-839-8888
Mailing Address - Fax:847-839-9660
Practice Address - Street 1:2357 HASSELL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2172
Practice Address - Country:US
Practice Address - Phone:847-839-8888
Practice Address - Fax:847-839-9660
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ80364Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER