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NPI Code Detail

MEDICARE: BEATRICE G DAMO

MEDICARE: BEATRICE G DAMO
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
1225100000XPhysical Therapist070014417IL

General Provider Information

NPI Number : 1053485763
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEATRICE G DAMO
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2222
Fax Number :
Provider Business Practice Location Address
First Line : 1010 EXECUTIVE DR STE 250
Second Line :
City : WESTMONT
State : IL
Zip : 60559-6137
Country : US
Telephone Number : 630-655-8785
Fax Number : 630-655-2759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 10/17/2018

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Directions to “ BEATRICE G DAMO ” Practice Location

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