MEDICARE: EL VALOR CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1407077969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL VALOR CORPORATION

Provider Business Mailing Address
First Line	:	1850 W 21ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2715
Country	:	US
Telephone Number	:	312-492-5930
Fax Number	:	312-666-0831

Provider Business Practice Location Address
First Line	:	1951 W 19TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2647
Country	:	US
Telephone Number	:	312-997-2021
Fax Number	:	312-432-9849

Authorized Official
Title or Position	:	VICE PRESIDENT FISCAL OPERATIONS
Name	:	MR. DAN OVERSTREET
Credential	:
Telephone Number	:	312-492-5930

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	04/12/2013

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Directions to “EL VALOR CORPORATION ” Practice Location

Language	Start Address	Practice Location

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