MEDICARE: MS. SANDRA JEAN HILTON PT

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	225100000X	Physical Therapist	070017765	IL

General Provider Information

NPI Number	:	1053386680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA JEAN HILTON PT

Provider Business Mailing Address
First Line	:	1925 N CLYBOURN AVE
Second Line	:	SUITE 302
City	:	CHICAGO
State	:	IL
Zip	:	60614-4946
Country	:	US
Telephone Number	:	773-747-4072
Fax Number	:	773-747-4069

Provider Business Practice Location Address
First Line	:	1925 N CLYBOURN AVE
Second Line	:	SUITE 302
City	:	CHICAGO
State	:	IL
Zip	:	60614-4946
Country	:	US
Telephone Number	:	773-747-4072
Fax Number	:	773-747-4069

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	02/13/2013

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