MEDICARE: CENTRE PHYSICAL THERAPY

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

General Provider Information

NPI Number	:	1245739473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	207 HARRISON ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60304-1533
Country	:	US
Telephone Number	:	708-210-9800
Fax Number	:	708-628-4189

Provider Business Practice Location Address
First Line	:	207 HARRISON ST
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60304-1533
Country	:	US
Telephone Number	:	312-391-8752
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CATHERINE STEGEMANN
Credential	:	PT
Telephone Number	:	708-210-9800

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	11/20/2019

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Directions to “CENTRE PHYSICAL THERAPY ” Practice Location

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