| Doctor Name: | JILLIAN RENEE GIDCUMB |
| NPI Number: | 1457516171 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 070-016483 |
| Business Practice Address: | 1505 Us Highway 41 Suite A20 Schererville, IN - 463751321 |
| Business Phone Number: | 2193225560 |
| Business Fax Number: | 2193221549 |
| Mailing Address: | 931 Ridge Rd, Suite G MUNSTER |
| State: | IN |
| Postal Code: | 463211755 |
| Phone Number: | 2198362800 |
| Fax Number: | 2198362897 |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 05/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070-016483 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |