Individual
MS. ABIGAIL VELASQUEZ GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 774-8000
(773) 990-7788
Mailing address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 774-8000
(773) 990-7788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070014889
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634372
BCBS GROUP NO.
IL
01
—
1618443
BCBS GROUP NO.
IL
01
—
200573902
GROUP TAX ID
IL
05
—
236963283001
—
IL
01
—
363396874
GROUP TAX ID NO.
IL
Enumeration date
06/19/2006
Last updated
08/13/2012
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