Provider Demographics
NPI:1942677737
Name:GABBEY, ATSUKO ANEGAWA (MOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ATSUKO
Middle Name:ANEGAWA
Last Name:GABBEY
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 W 14TH PL
Mailing Address - Street 2:UNIT 119
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2285
Mailing Address - Country:US
Mailing Address - Phone:773-742-8409
Mailing Address - Fax:
Practice Address - Street 1:1033 W 14TH PL
Practice Address - Street 2:UNIT 119
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2285
Practice Address - Country:US
Practice Address - Phone:773-742-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056011141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist