Provider Demographics
NPI:1912374729
Name:GAHART, CAITLIN WINIFRED (DPT, PT)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:WINIFRED
Last Name:GAHART
Suffix:
Gender:
Credentials:DPT, PT
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:WINIFRED
Other - Last Name:MCNULTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:229 EAST PARK AVE
Mailing Address - Street 2:APT 2E
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048
Mailing Address - Country:US
Mailing Address - Phone:847-767-1484
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:37 SHERWOOD TERRACE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044
Practice Address - Country:US
Practice Address - Phone:847-235-2392
Practice Address - Fax:847-235-2061
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070021747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist