Individual
AMANDA M GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
999 E TOUHY AVE STE 450, DES PLAINES, IL 60018-2748
(630) 920-2323
(630) 232-5625
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-018805
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01040909
MEDICARE RAILROAD
IL
Enumeration date
10/19/2011
Last updated
12/05/2019
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