Individual provider Active NPI

Yvonne Gagliano, P.T.

  • Physical Therapist
  • Crystal Lake, IL
National Provider Identifier
1881653020
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6332 Issued in AZ
Practice address
407 E Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3602
Phone
(847) 766-0011
Fax
(847) 999-6722
NPI assigned
Mar 17, 2006
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6332 AZ Primary

Addresses

Primary practice location

407 E Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3602

Mailing address

407 E Terra Cotta Ave Ste E
Crystal Lake, IL 60014-3602
Phone (847) 766-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100517000190 IL Practitioner - Physical Therapist in Private Practice 0749264364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Given Sports & Physical Therapy, P.C. CurrentSince Nov 17, 2024 Accepting new patients
Titan Medical Associates LTD. CurrentSince Oct 16, 2022 Accepting new patients
Orthosports Physical Therapy PastSince Nov 1, 2015 Accepting new patients
Arizona Orthosports Physical Therapy, Inc Physical Therapist PastSince Sep 1, 2006 Accepting new patients
Advanced Physical Medicine & Rehabilitation LTD PastSince Sep 29, 2024 Accepting new patients

Locations

407 E Terra Cotta Ave
Ste E
Crystal Lake, IL 60014
Phone (815) 477-8004

999 W Main St
Ste 100
West Dundee, IL 60118
Phone (224) 535-8707

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1881653020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E TERRA COTTA AVE STE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143602",
            "telephone_number": "847-766-0011",
            "fax_number": "847-999-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E TERRA COTTA AVE STE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143602",
            "telephone_number": "847-766-0011",
            "fax_number": "847-999-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIANO",
        "first_name": "YVONNE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6332",
            "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 Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.