MEDICARE: BRETT PAINTER DPT PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251S0007X	Sports Physical Therapist
2	2251X0800X	Orthopedic Physical Therapist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1114486099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRETT PAINTER DPT PC

Provider Business Mailing Address
First Line	:	435 W ERIE ST APT 1605
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-6985
Country	:	US
Telephone Number	:	815-978-3298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 W ARMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4103
Country	:	US
Telephone Number	:	815-978-3298
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRETT PAINTER
Credential	:	PT, DPT, COMT
Telephone Number	:	815-978-3298

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	03/19/2019

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Directions to “BRETT PAINTER DPT PC ” Practice Location

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