Active NPI
Gem U Catama, PTA
- Physical Therapy Assistant
- Waukegan, IL
National Provider Identifier
1962855858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160007508
- Practice address
- 1720 Grand Ave
Waukegan, IL 60085-3502 - Phone
- (847) 625-0202
- Fax
- (847) 625-0101
- NPI assigned
- Jul 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160007508 | IL | Primary |
Addresses
Primary practice location
1720 Grand Ave
Waukegan, IL 60085-3502
Mailing address
1720 Grand Ave
Waukegan, IL 60085-3502
Phone (847) 625-0202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 160007508 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1962855858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600853502",
"telephone_number": "847-625-0202",
"fax_number": "847-625-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600853502",
"telephone_number": "847-625-0202",
"fax_number": "847-625-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CATAMA",
"first_name": "GEM",
"middle_name": "U",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-15",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160007508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.