MEDICARE: AMBER L VAUGHAN 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
1	225100000X	Physical Therapist	070018536	IL

General Provider Information

NPI Number	:	1699053793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER L VAUGHAN PT

Provider Business Mailing Address
First Line	:	1615 HART RD
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-9316
Country	:	US
Telephone Number	:	815-593-6633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 HART RD
Second Line	:
City	:	BATAVIA
State	:	IL
Zip	:	60510-9316
Country	:	US
Telephone Number	:	815-593-6633
Fax Number	:

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	03/14/2024

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Directions to “ AMBER L VAUGHAN PT” Practice Location

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