MEDICARE: CHELSEA BARTHOLOMEW 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
1	225100000X	Physical Therapist	5501018015	MI

General Provider Information

NPI Number	:	1457899312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA BARTHOLOMEW DPT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:	630-296-2222
Fax Number	:	630-759-9510

Provider Business Practice Location Address
First Line	:	2510 S TELEGRAPH RD
Second Line	:	SUITE I & J
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0241
Country	:	US
Telephone Number	:	248-335-2000
Fax Number	:	248-335-2002

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

Provider Enumeration Date	:	02/10/2017
Last Update Date	:	02/10/2017

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