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NPI Code Detail

MEDICARE: CLAIRE SOMARRIBA PTA

MEDICARE: CLAIRE SOMARRIBA PTA
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
1208100000XPhysical Medicine & Rehabilitation Physician160006472IL

General Provider Information

NPI Number : 1487117784
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE SOMARRIBA PTA
Provider Business Mailing Address
First Line : 547 GUNNISON CT
Second Line :
City : GILBERTS
State : IL
Zip : 60136-4083
Country : US
Telephone Number : 224-523-0093
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LAKE COOK RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-1112
Country : US
Telephone Number : 847-562-1770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2019
Last Update Date : 04/12/2019

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