MEDICARE: MARIA CHURAK P.T.

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	070.011263	IL

General Provider Information

NPI Number	:	1447314497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CHURAK P.T.

Provider Business Mailing Address
First Line	:	350 SURRYSE RD STE 200
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-3217
Country	:	US
Telephone Number	:	847-842-4057
Fax Number	:	847-842-4059

Provider Business Practice Location Address
First Line	:	350 SURRYSE RD
Second Line	:
City	:	LAKE ZURICH
State	:	IL
Zip	:	60047-3217
Country	:	US
Telephone Number	:	847-842-4057
Fax Number	:

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	02/25/2022

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Directions to “ MARIA CHURAK P.T.” Practice Location

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