Provider Demographics
NPI:1922010990
Name:FERREBEE, GAIL (PT)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:FERREBEE
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 1:1230 N CONVENT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1474
Mailing Address - Country:US
Mailing Address - Phone:815-935-8782
Mailing Address - Fax:815-935-8799
Practice Address - Street 1:1230 N CONVENT ST
Practice Address - Street 2:SUITE A
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1474
Practice Address - Country:US
Practice Address - Phone:815-935-8782
Practice Address - Fax:815-935-8799
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL326700Medicare ID - Type Unspecified