MEDICARE: REBECCA HARDY

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1225534704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HARDY

Provider Business Mailing Address
First Line	:	1506 W ARTHUR AVE APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-6645
Country	:	US
Telephone Number	:	252-375-5149
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 S PROMONTORY DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-1002
Country	:	US
Telephone Number	:	773-363-6700
Fax Number	:	773-363-3481

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

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	02/18/2022

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Directions to “ REBECCA HARDY ” Practice Location

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