MEDICARE: DR. SANDRA SCANLAN PT, DPT

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	208100000X	Physical Medicine & Rehabilitation Physician	10766	AZ
2	208100000X	Physical Medicine & Rehabilitation Physician	070020631	IL

General Provider Information

NPI Number	:	1871905240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA SCANLAN PT, DPT

Provider Business Mailing Address
First Line	:	11 E SANDSTONE CT
Second Line	:
City	:	SOUTH ELGIN
State	:	IL
Zip	:	60177-3260
Country	:	US
Telephone Number	:	224-406-0713
Fax Number	:

Provider Business Practice Location Address
First Line	:	1956 W SPRING RIDGE DR
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1220
Country	:	US
Telephone Number	:	224-406-0713
Fax Number	:

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

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	11/28/2022

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