Garry Gabionza Tagle, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013388 Issued in IL

Practice address

221 N Marion St
Unit 1a
Oak Park, IL 60302-1936

Phone

(708) 386-0136

NPI assigned

Oct 9, 2009

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Direct Access Therapy IncGroup PAC ID 1355418682, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Direct Access Therapy, Inc

  • Physical Therapist
  • Oak Park, IL
  • NPI 1902072523
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1629303607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N MARION ST",
            "address_2": "UNIT 1A",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021936",
            "telephone_number": "708-386-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N MARION ST",
            "address_2": "UNIT 1A",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021936",
            "telephone_number": "708-386-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGLE",
        "first_name": "GARRY",
        "middle_name": "GABIONZA",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Michelle Taback, M.D.
• Viktor Tabatchyk, S.A.
• Stephanie Tabor
• Brooke Taeckens
• Tiffany H Taft, PSYD
• Talk With Me Inc
• Daniel Talley
• Tamar Levinson LTD.
• Alex R Tan, OD
• Amanda Tanaka

• Physical Therapist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; 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.