MEDICARE: MRS. DEBORAH J ZORN 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

General Provider Information

NPI Number	:	1275749269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH J ZORN PT

Provider Business Mailing Address
First Line	:	3711 PITZEN RD
Second Line	:
City	:	JOHNSBURG
State	:	IL
Zip	:	60051-3735
Country	:	US
Telephone Number	:	815-385-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 NORTHWEST HWY
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-8058
Country	:	US
Telephone Number	:	815-455-9800
Fax Number	:	815-455-9359

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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