MEDICARE: ANN TORP 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	227014648	IL

General Provider Information

NPI Number	:	1831443100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN TORP LMT

Provider Business Mailing Address
First Line	:	2 RIDGELAND AVE
Second Line	:
City	:	FOX LAKE
State	:	IL
Zip	:	60020-1824
Country	:	US
Telephone Number	:	847-445-6854
Fax Number	:

Provider Business Practice Location Address
First Line	:	34121 N US HIGHWAY 45
Second Line	:	STE 202
City	:	GRAYSLAKE
State	:	IL
Zip	:	60030-1768
Country	:	US
Telephone Number	:	847-445-6854
Fax Number	:

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

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	11/07/2012

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