Gaston D Cordova, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070014706 Issued in IL

Practice address

4390 Il-71
Oswego, IL 60543

Phone

(630) 554-1001

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Grayslake, IL
  • NPI 1689141376
  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD
• Athletic &Therapeutic Institute of Naperville, LLC

  • Physical Therapist
  • Joliet, IL
  • NPI 1598872921
  NPD (past)
• Athletic and Therapeutic Institute of Joliet LLC

  • Physical Therapist
  • Joliet, IL
  • NPI 1932249109
  NPD (past)
• Athletic and Therapeutic Institute of Naperville, LLC

  • Physical Therapist
  • Willowbrook, IL
  • NPI 1144331794
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1205928710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SANTA FE LN",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 IL-71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "GASTON",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Conard
• Christine Conover, RD, LDN
• Lacy Holt Cook Jr., D.C.
• Christina Elise Cooper, LCSW
• Pamela J Copeland, LCSW
• Corh Counseling, PC
• Cornerstone Therapy Group, PLLC
• John Cosma, PSYD
• Jennifer R Crane, MD
• Brian T Cronin, ATC

• Physical Therapist in Oswego, IL
• Providers in Oswego, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.