Provider Demographics
NPI:1184947897
Name:GENATO, MONALIE CORTEZ (PT)
Entity type:Individual
Prefix:
First Name:MONALIE
Middle Name:CORTEZ
Last Name:GENATO
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 1:16101 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-8812
Mailing Address - Country:US
Mailing Address - Phone:815-306-1100
Mailing Address - Fax:815-306-1105
Practice Address - Street 1:16101 WEBER RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-8812
Practice Address - Country:US
Practice Address - Phone:815-306-1100
Practice Address - Fax:815-306-1105
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist