Individual ProviderJan Andy Dongon GatilloPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address5946 N Milwaukee Ave, Chicago, IL 60646-5424(773) 775-6637(224) 266-7819PECOS EnrollmentBased on the most recent information from CMS, provider Jan Andy Dongon Gatillo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1558967828Provider TypeIndividualFull NameGatillo, Jan Andy DongonGenderMaleSole ProprietorNoEnumeration Date12/10/2020Last Updated12/10/2020Contact InformationPractice LocationPractice Address5946 N Milwaukee Ave, Chicago, IL 60646-5424Phone(773) 775-6637Fax(773) 775-6638Mailing LocationMailing Address8739 N Elmore St, Niles, IL 60714-1943Phone(224) 266-7819FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense070022295Illinois