MEDICARE: KARINA V ECKERT LMT

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	225700000X	Massage Therapist	227016217	IL

General Provider Information

NPI Number	:	1659078525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA V ECKERT LMT

Provider Business Mailing Address
First Line	:	1051 VALLEY STREAM DR
Second Line	:
City	:	PINGREE GROVE
State	:	IL
Zip	:	60140-9137
Country	:	US
Telephone Number	:	773-304-6346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 VALLEY STREAM DR
Second Line	:
City	:	PINGREE GROVE
State	:	IL
Zip	:	60140-9137
Country	:	US
Telephone Number	:	773-304-6346
Fax Number	:

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

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/13/2023

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Directions to “ KARINA V ECKERT LMT” Practice Location

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