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NPI Code Detail

MEDICARE: MICHELLE SHUFELT P.T

MEDICARE: MICHELLE SHUFELT P.T
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
1225100000XPhysical TherapistIL

General Provider Information

NPI Number : 1063569747
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE SHUFELT P.T
Provider Business Mailing Address
First Line : 2800 N LAKE SHORE DR
Second Line : APT. 3604
City : CHICAGO
State : IL
Zip : 60657-6232
Country : US
Telephone Number : 312-225-3119
Fax Number : 312-225-3219
Provider Business Practice Location Address
First Line : 412 W 31ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3116
Country : US
Telephone Number : 312-225-3119
Fax Number : 312-225-3219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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Directions to “ MICHELLE SHUFELT P.T” Practice Location

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