MEDICARE: MRS. GERI HALLMAN MASSAGE 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	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1598832685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GERI HALLMAN MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	1705 BROOKWOOD DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2353
Country	:	US
Telephone Number	:	630-293-8698
Fax Number	:	630-231-8722

Provider Business Practice Location Address
First Line	:	1705 BROOKWOOD DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2353
Country	:	US
Telephone Number	:	630-293-8698
Fax Number	:	630-231-8722

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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