Individual provider Active NPI

Gina Huber, PT

  • Physical Therapist
  • Crystal Lake, IL
National Provider Identifier
1093187262
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21189 Issued in NC
Practice address
200 E Congress Pkwy
Crystal Lake, IL 60014-6268
Phone
(815) 477-4348
Fax
(815) 477-5828
NPI assigned
Oct 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07-0008952 IL
Physical Therapist 225100000X P21189 NC Primary

Addresses

Primary practice location

200 E Congress Pkwy
Crystal Lake, IL 60014-6268

Mailing address

204 Foxford Dr
Cary, IL 60013-1113
Phone (847) 845-6901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07-0008952ILMDPhysical Therapist
P21189NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of NC PC Physical Therapist PastSince Nov 4, 2024 Accepting new patients
American Chiropractic Center, Inc. PastSince Jul 1, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1093187262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 FOXFORD DR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600131113",
            "telephone_number": "847-845-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CONGRESS PKWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146268",
            "telephone_number": "815-477-4348",
            "fax_number": "815-477-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER",
        "first_name": "GINA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "07-0008952",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.