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General NPI Number Information
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NPI Number | 1386012102
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Entity Type | Individual
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Provider Name | EMILY AUGUSTA LETARTE PT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 4700 N WESTERN AVE STE 2
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City | CHICAGO
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State | IL
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Zip | 60625-6999
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Country | US
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Telephone | 773-435-9275
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Fax | 773-945-9112
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523
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Country | US
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Telephone | 630-575-1980
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Fax | 630-928-5080
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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 | 070021871
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License Number State | IL
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