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NPI Code Detail

MEDICARE: MICHAEL RAUWOLF PT

MEDICARE: MICHAEL RAUWOLF 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
1225100000XPhysical Therapist070023136IL

General Provider Information

NPI Number : 1528587631
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RAUWOLF PT
Provider Business Mailing Address
First Line : 24014 W RENWICK RD STE F
Second Line :
City : PLAINFIELD
State : IL
Zip : 60544-8708
Country : US
Telephone Number : 800-974-4378
Fax Number : 630-515-1536
Provider Business Practice Location Address
First Line : 18215 HARLEM AVE
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-3609
Country : US
Telephone Number : 800-974-4378
Fax Number : 630-515-1536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2017
Last Update Date : 04/07/2022

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