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NPI Code Detail

MEDICARE: VICTORIA BEDWELL DPT

MEDICARE: VICTORIA BEDWELL DPT
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 Therapist070.024303IL

General Provider Information

NPI Number : 1144887217
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA BEDWELL DPT
Provider Business Mailing Address
First Line : 5100 FOREST AVE UNIT 318
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-4866
Country : US
Telephone Number : 815-274-5515
Fax Number :
Provider Business Practice Location Address
First Line : 355 E ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3167
Country : US
Telephone Number : 312-238-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2019
Last Update Date : 05/23/2019

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Directions to “ VICTORIA BEDWELL DPT” Practice Location

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