MEDICARE: ANDA K ZAVADA 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	2251X0800X	Orthopedic Physical Therapist	05002259	IN
2	225100000X	Physical Therapist	05002259	IN

General Provider Information

NPI Number	:	1235506940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDA K ZAVADA PT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 US HIGHWAY 41
Second Line	:
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-2892
Country	:	US
Telephone Number	:	219-365-1242
Fax Number	:	219-356-1243

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

Provider Enumeration Date	:	08/28/2015
Last Update Date	:	05/30/2024

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Directions to “ ANDA K ZAVADA PT” Practice Location

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