MEDICARE: MRS. KAROL A STEELE PTA

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	225200000X	Physical Therapy Assistant		IL

General Provider Information

NPI Number	:	1932372588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAROL A STEELE PTA

Provider Business Mailing Address
First Line	:	620 FYRE LAKE DRIVE
Second Line	:
City	:	SHERRARD
State	:	IL
Zip	:	61281
Country	:	US
Telephone Number	:	309-593-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 FYRE LAKE DRIVE
Second Line	:
City	:	SHERRARD
State	:	IL
Zip	:	61281
Country	:	US
Telephone Number	:	309-593-2832
Fax Number	:

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

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	04/03/2008

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