Individual
MR. GERALD DEAN PICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 337-2377
(217) 326-2324
Mailing address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-3400
(217) 326-2324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.002194
IL
225100000X
Physical Therapist
070002194
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROV ID
—
01
—
203
BLUE CROSS PROV ID
IL
01
—
4117
HAMP PROV ID
IL
01
—
7216
PERSONALCARE PROV ID
—
Enumeration date
03/22/2007
Last updated
10/04/2013
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