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NPI 1467576009

NPI 1467576009 : MAUREEN CECILIA KASPER P.T. : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1467576009
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    Entity Type          |    Individual 
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    Provider Name        |    MAUREEN CECILIA KASPER P.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/19/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    10201 S WESTERN AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60643-1917
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    Country              |    US
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    Telephone            |    773-779-7273
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    Fax                  |    773-779-7298
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Provider Business Mailing Address
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    Address Line         |    5221 OAK ST 
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    City                 |    OAK LAWN
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    State                |    IL
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    Zip                  |    60453-2428
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    Country              |    US
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    Telephone            |    708-424-9030
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    Fax                  |    773-779-7298
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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       |    070-012996
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    License Number State |    IL
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