MEDICARE: MR. RODOLFO T ABIERA PHYSICAL THERAPIST

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01683332	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1295893147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RODOLFO T ABIERA PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	1205 SOUTH PARK AVE
Second Line	:
City	:	STREAMWOOD
State	:	IL
Zip	:	60107-2902
Country	:	US
Telephone Number	:	630-837-6980
Fax Number	:	630-837-6980

Provider Business Practice Location Address
First Line	:	1205 SOUTH PARK AVE
Second Line	:
City	:	STREAMWOOD
State	:	IL
Zip	:	60107-2902
Country	:	US
Telephone Number	:	630-837-6980
Fax Number	:	630-837-6980

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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