MEDICARE: STEPHANIE ANNE THERAPY, PLLC

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
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1114581337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANIE ANNE THERAPY, PLLC

Provider Business Mailing Address
First Line	:	755 ELA RD STE A
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-2412
Country	:	US
Telephone Number	:	847-320-0200
Fax Number	:	847-327-0857

Provider Business Practice Location Address
First Line	:	755 ELA RD STE A
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-2412
Country	:	US
Telephone Number	:	847-320-0200
Fax Number	:	847-327-0857

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	STEPHANIE VOGLER
Credential	:	OTR/L
Telephone Number	:	847-320-0200

Provider Enumeration Date	:	04/23/2019
Last Update Date	:	08/02/2024

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