Basic Information
| Provider Information | |||||||||
| NPI: | 1467433268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GASPARI | ||||||||
| FirstName: | JUSTINE | ||||||||
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| Credential: | ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 527 N PLAMONDON DR | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601011933 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 W OGDEN AVE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | HINSDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605213186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306558785 | ||||||||
| FaxNumber: | 6306552759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.