MEDICARE: MS. MARY SUSAN BEAMER PT, MA, CHT

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	070005208	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1619980	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1215986302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY SUSAN BEAMER PT, MA, CHT

Provider Business Mailing Address
First Line	:	244 HAWK CT
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-5709
Country	:	US
Telephone Number	:	847-798-6513
Fax Number	:

Provider Business Practice Location Address
First Line	:	1443 W SCHAUMBURG RD
Second Line	:	STE 102
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-4065
Country	:	US
Telephone Number	:	847-895-2910
Fax Number	:

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	05/16/2013

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