MEDICARE: LINDA ANNE SCHRAUTH PT

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1635017	OTHER		BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1164477949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ANNE SCHRAUTH PT

Provider Business Mailing Address
First Line	:	1635 HAWTHORNE LN
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-2262
Country	:	US
Telephone Number	:	847-998-9682
Fax Number	:	847-998-6476

Provider Business Practice Location Address
First Line	:	910A WAUKEGAN RD
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-4315
Country	:	US
Telephone Number	:	847-657-0881
Fax Number	:	847-657-0880

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/09/2007

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Directions to “ LINDA ANNE SCHRAUTH PT” Practice Location

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