Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070.023522 | IL |
N | 2251P0200X | Physical Therapist - Pediatrics | 070.023522 | IL |
NPI | 1134629777 |
---|---|
Provider Name | Erin Maureen Gaffney |
First Address | Chicago, IL 60614-2105 |
Second Address | Chicago, IL 60614-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 20/02/2018 |