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NPI Code Detail

MEDICARE: ASHLEY FERRELL DPT

MEDICARE: ASHLEY FERRELL DPT
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
1225100000XPhysical Therapist070020704IL

General Provider Information

NPI Number : 1427483924
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY FERRELL DPT
Provider Business Mailing Address
First Line : 18428 GOVERNORS HWY
Second Line :
City : HOMEWOOD
State : IL
Zip : 60430-2911
Country : US
Telephone Number : 708-799-5569
Fax Number : 708-799-5569
Provider Business Practice Location Address
First Line : 5525 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4400
Country : US
Telephone Number : 312-567-7508
Fax Number : 708-799-5569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2013
Last Update Date : 12/27/2016

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