MEDICARE: MIDWEST THERAPY NETWORK LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1093959652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST THERAPY NETWORK LLC

Provider Business Mailing Address
First Line	:	855 E GOLF RD
Second Line	:	STE. 2133
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-5222
Country	:	US
Telephone Number	:	630-607-2038
Fax Number	:	847-290-9133

Provider Business Practice Location Address
First Line	:	855 E GOLF RD
Second Line	:	STE. 2133
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-5222
Country	:	US
Telephone Number	:	630-607-2038
Fax Number	:	847-290-9133

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CESAR JAVIER
Credential	:
Telephone Number	:	630-607-2038

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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