MEDICARE: EMILY JAVIER

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	225100000X	Physical Therapist	070020667	IL

General Provider Information

NPI Number	:	1013321934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JAVIER

Provider Business Mailing Address
First Line	:	2569 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2569 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3147
Country	:	US
Telephone Number	:	773-252-4921
Fax Number	:

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

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	10/12/2021

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Directions to “ EMILY JAVIER ” Practice Location

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