MEDICARE: BEATRICE DEFRANCO LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	227.015376	IL

General Provider Information

NPI Number	:	1023885308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE DEFRANCO LMT

Provider Business Mailing Address
First Line	:	7777 LAKE ST.
Second Line	:	#106
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-1734
Country	:	US
Telephone Number	:	708-860-1881
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 LAKE ST.
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-1734
Country	:	US
Telephone Number	:	708-860-1881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	12/07/2023

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