MEDICARE: NATURAL INSTINCTS

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	070009896	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1636233	OTHER	IL	BCBS PPO

General Provider Information

NPI Number	:	1093756470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL INSTINCTS

Provider Business Mailing Address
First Line	:	11617 S ADA ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-5126
Country	:	US
Telephone Number	:	773-469-1183
Fax Number	:	773-568-5629

Provider Business Practice Location Address
First Line	:	11113 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3907
Country	:	US
Telephone Number	:	773-469-1183
Fax Number	:	773-568-5629

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MS. TINA RENEE MOROCCO-COLLINS
Credential	:
Telephone Number	:	773-469-1183

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	05/19/2015

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Directions to “NATURAL INSTINCTS ” Practice Location

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