MEDICARE: LINDA HENSON

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	070.004507	IL

General Provider Information

NPI Number	:	1639562648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA HENSON

Provider Business Mailing Address
First Line	:	4724 FOREST AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3525
Country	:	US
Telephone Number	:	630-242-0841
Fax Number	:

Provider Business Practice Location Address
First Line	:	4724 FOREST AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3525
Country	:	US
Telephone Number	:	630-242-0841
Fax Number	:

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

Provider Enumeration Date	:	03/16/2015
Last Update Date	:	03/16/2015

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Directions to “ LINDA HENSON ” Practice Location

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