Provider Demographics
NPI:1699734541
Name:GREGORY, ANDREA ANN (DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ANN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:ANN
Other - Last Name:VIERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:312-640-0407
Practice Address - Street 1:800 COLONIAL CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9616
Practice Address - Country:US
Practice Address - Phone:515-953-1310
Practice Address - Fax:515-953-1322
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist