MEDICARE: PRECISION HAND THERAPY 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1225333248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION HAND THERAPY LLC

Provider Business Mailing Address
First Line	:	712 N DEARBORN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3846
Country	:	US
Telephone Number	:	312-951-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 N DEARBORN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3846
Country	:	US
Telephone Number	:	312-951-8200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. IRVIN WIESMAN
Credential	:	M.D.
Telephone Number	:	312-951-8200

Provider Enumeration Date	:	01/22/2011
Last Update Date	:	10/02/2014

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Directions to “PRECISION HAND THERAPY LLC ” Practice Location

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