Provider Demographics
NPI:1992749634
Name:MCELVEEN, GRETCHEN (PT)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:MCELVEEN
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 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:634 1ST ST N STE 100
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-9263
Practice Address - Country:US
Practice Address - Phone:205-728-2535
Practice Address - Fax:205-728-2536
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532785OtherBCBS
AL51533284OtherBCBS
AL51533288OtherBCBS
AL51533291OtherBCBS
AL51533290OtherBCBS
AL51533293OtherBCBS
AL51533292OtherBCBS
AL51533300OtherBCBS
AL51533299OtherBCBS