Individual
GINO JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1480 DOUGLAS RD, OSWEGO, IL 60543-5106
(331) 216-0100
(331) 330-2081
Mailing address
PO BOX 416501, BOSTON, MA 02241-7594
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
070022493
IL
225100000X
Physical Therapist
05012862A
IN
2251X0800X
Orthopedic Physical Therapist
Primary
070022493
IL
Other
Enumeration date
09/01/2016
Last updated
01/17/2024
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