MEDICARE: SHELBY TOENNIES

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	:	1356946685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY TOENNIES

Provider Business Mailing Address
First Line	:	219 WHITETAIL XING
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-8639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 W HIGGINS RD STE 370
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-7207
Country	:	US
Telephone Number	:	847-895-2910
Fax Number	:

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

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	08/24/2021

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Directions to “ SHELBY TOENNIES ” Practice Location

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