MEDICARE: DR. HAILEY NICOLE TENHUISEN PT, DPT

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

General Provider Information

NPI Number	:	1164354528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAILEY NICOLE TENHUISEN PT, DPT

Provider Business Mailing Address
First Line	:	6505 N ASHLAND AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4950
Country	:	US
Telephone Number	:	812-272-9926
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1443
Country	:	US
Telephone Number	:	888-824-0200
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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