Provider Demographics
NPI:1306689492
Name:MISKA, GILDA CORTES (PT)
Entity type:Individual
Prefix:MRS
First Name:GILDA
Middle Name:CORTES
Last Name:MISKA
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 1:5737 N KENMORE AVE APT 212
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4533
Mailing Address - Country:US
Mailing Address - Phone:312-852-6331
Mailing Address - Fax:
Practice Address - Street 1:9700 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1175
Practice Address - Country:US
Practice Address - Phone:847-929-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.021394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist