MEDICARE: PAMELA SANTA PT

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	070016900	IL

General Provider Information

NPI Number	:	1427297860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA SANTA PT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-1980
Fax Number	:	630-928-5080

Provider Business Practice Location Address
First Line	:	205 S GARY AVE
Second Line	:
City	:	BLOOMINGDALE
State	:	IL
Zip	:	60108-2213
Country	:	US
Telephone Number	:	630-307-5910
Fax Number	:	630-307-5913

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

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	07/08/2021

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Directions to “ PAMELA SANTA PT” Practice Location

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