Individual provider Active NPI

Sarah Elizabeth Del Gallo, PTA

  • Physical Therapy Assistant
  • Glen Ellyn, IL
National Provider Identifier
1306077466
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.004086 Issued in IL
Practice address
875 Roosevelt Road
Glen Ellyn, IL 60139
Phone
(630) 469-7858
Fax
(630) 469-0098
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.004086 IL Primary

Addresses

Primary practice location

875 Roosevelt Road
Glen Ellyn, IL 60139

Mailing address

875 Roosevelt Road
Glen Ellyn, IL 60139
Phone (630) 469-7858

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160.004086ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1306077466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 ROOSEVELT ROAD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "630-469-7858",
            "fax_number": "630-469-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 ROOSEVELT ROAD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "630-469-7858",
            "fax_number": "630-469-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL GALLO",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.004086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.