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NPI Code Detail

MEDICARE: JOSE SEGURA MPT

MEDICARE:   JOSE  SEGURA  MPT
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 Therapist070009680IL

General Provider Information

NPI Number : 1437291242
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE SEGURA MPT
Provider Business Mailing Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4210
Country : US
Telephone Number : 773-241-6450
Fax Number : 773-241-6501
Provider Business Practice Location Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4210
Country : US
Telephone Number : 773-241-6450
Fax Number : 773-241-6501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 03/30/2009

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Directions to “ JOSE SEGURA MPT” Practice Location

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