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General NPI Number Information
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NPI Number | 1124217989
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Entity Type | Individual
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Provider Name | EVA RUTH SALAZAR RIECK PT
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Gender | Female
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 551 CHEYENNE TRL
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City | CAROL STREAM
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State | IL
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Zip | 60188-1540
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Country | US
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Telephone | 630-242-0200
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Fax | 630-456-4792
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Provider Business Mailing Address
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Address Line | 551 CHEYENNE TR
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City | CAROL STREAM
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State | IL
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Zip | 60188
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Country | US
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Telephone | 630-242-0200
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Fax | 630-456-4792
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070015848
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License Number State | IL
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