LAKSHMI KALYANI GUDAVALLI (NPI# 1063814309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063814309 |
| Entity Type | Individual |
| Full Name | LAKSHMI KALYANI GUDAVALLI |
| Credential | PT |
| Practice Address |
275 E Carl Sandburg Drive Marigold Rehabilitation Galesburg IL 61401 |
| Mailing Address |
2834 Villa Ct Bettendorf IA 52722-7554 |
| Practice Telephone | 3093441151 |
| Mailing Telephone | 5636392486 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
070020357 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
275 E CARL SANDBURG DRIVE MARIGOLD REHABILITATION |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| 1508939794 | Mohammad Sami | Psychiatry & Neurology | 2323 Windish Drive, Bridgeway Inc, Galesburg, IL 61401 | 2006-11-16 |
| Find all providers in zip 61401 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986891 | Murtaza Aziz | Physical Therapist | 1431 N Western Ave Ste 140, Chicago, IL 60622-1770 | 2020-09-14 |
| 1902416720 | Epicore Physical Therapy | Physical Therapist | 1660 N La Salle Dr Apt 2708, Chicago, IL 60614-6021 | 2020-08-06 |
| 1356968374 | Genevieve Joy Owen | Physical Therapist | 555 Busse Hwy Unit C1, Park Ridge, IL 60068-3189 | 2020-06-26 |
| 1518597772 | Stability Physical Therapy and Wellness, LLC | Physical Therapist | 5031 W Balmoral Ave, Chicago, IL 60630-1507 | 2020-01-16 |
| 1154972719 | Antonio Marquez | Physical Therapist | 7425 Janes Ave Ste 200, Woodridge, IL 60517-2358 | 2019-09-25 |
| 1376198978 | Natalie N Ruebke | Physical Therapist | 251 Marketplace Dr # 2, Freeburg, IL 62243-4082 | 2019-08-09 |
| 1902360241 | Stephanie Lynne Burkhart | Physical Therapist | 12251 W 159th St, Homer Glen, IL 60491-7847 | 2019-01-30 |
| 1003388943 | Scoliosis Therapy Care and More LLC | Physical Therapist | 4n369 Booth Tarkington St, St Charles, IL 60175-7731 | 2018-12-17 |
| 1912478082 | Brandon Donnelly | Physical Therapist | 2200 Fort Jesse Rd Ste 230, Normal, IL 61761-6291 | 2018-12-16 |
| 1497251086 | John William Herbert | Physical Therapist | 1316 N Route 59, Naperville, IL 60563-4286 | 2018-04-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.