Provider Demographics
NPI:1053411926
Name:CAHILL-MOHEN, GERALDINE A (PT)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:A
Last Name:CAHILL-MOHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 S STATE ST STE 1020
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2225
Mailing Address - Country:US
Mailing Address - Phone:877-632-6637
Mailing Address - Fax:
Practice Address - Street 1:833 S STATE ST STE 1020
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2225
Practice Address - Country:US
Practice Address - Phone:877-632-6637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL567700OtherMEDICARE GROUP NUMBER
IL568080OtherMEDICARE GROUP NUMBER
IL1619908OtherBCBS IL GROUP
IL568080OtherMEDICARE GROUP NUMBER
ILK45718Medicare PIN