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NPI Code Detail

MEDICARE: THOMAS MCCORMACK PT

MEDICARE:   THOMAS  MCCORMACK  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
1225100000XPhysical Therapist070-005316IL

General Provider Information

NPI Number : 1194985358
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MCCORMACK PT
Provider Business Mailing Address
First Line : 412 W 31ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3116
Country : US
Telephone Number : 312-225-3119
Fax Number : 773-657-3895
Provider Business Practice Location Address
First Line : 7238 N HARLEM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60631-4335
Country : US
Telephone Number : 773-657-3897
Fax Number : 773-657-3895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2008
Last Update Date : 05/05/2022

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Directions to “ THOMAS MCCORMACK PT” Practice Location

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