Individual
MRS. JOHANNA J GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0264751
NY
225100000X
Physical Therapist
Primary
05009117A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000509686
ANTHEM ID
IN
05
—
02648722
—
NY
05
—
200850220
—
IN
Enumeration date
03/22/2006
Last updated
01/03/2025
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