MEDICARE: MR. EARL EDWARD GUNTHER JR. 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
1	225100000X	Physical Therapist	070010574	IL
2	2251S0007X	Sports Physical Therapist	070010574	IL
3	2251X0800X	Orthopedic Physical Therapist	070010574	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1634788	OTHER	IL	BLUE CROSS GROUP NUMBER
2	7739664	OTHER	IL	AETNA PROVIDER ID
3	070010574	OTHER	IL	PT LISCENCE NUMBER

General Provider Information

NPI Number	:	1144230582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EARL EDWARD GUNTHER JR. P.T.

Provider Business Mailing Address
First Line	:	1443 W SCHAUMBURG RD
Second Line	:	SUITE 102
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-4065
Country	:	US
Telephone Number	:	847-895-2910
Fax Number	:	847-895-2911

Provider Business Practice Location Address
First Line	:	1443 W SCHAUMBURG RD
Second Line	:	SUITE 102
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-4065
Country	:	US
Telephone Number	:	847-895-2910
Fax Number	:	847-895-2911

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	11/20/2013

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Directions to “ MR. EARL EDWARD GUNTHER JR. P.T.” Practice Location

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