Provider Demographics
NPI:1962855858
Name:CATAMA, GEM U (PTA)
Entity Type:Individual
Prefix:MR
First Name:GEM
Middle Name:U
Last Name:CATAMA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-3502
Mailing Address - Country:US
Mailing Address - Phone:847-625-0202
Mailing Address - Fax:847-625-0101
Practice Address - Street 1:1720 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-3502
Practice Address - Country:US
Practice Address - Phone:847-625-0202
Practice Address - Fax:847-625-0101
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160007508225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant