MEDICARE: MR. HARRY M SILVERMAN IV

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	070-005426	IL

General Provider Information

NPI Number	:	1144206905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HARRY M SILVERMAN IV

Provider Business Mailing Address
First Line	:	2028 W OAKTON
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1958
Country	:	US
Telephone Number	:	847-685-0693
Fax Number	:

Provider Business Practice Location Address
First Line	:	2028 W OAKTON
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1958
Country	:	US
Telephone Number	:	847-685-0693
Fax Number	:

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/26/2013

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