MEDICARE: YELENA K ADANIN 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	2251P0200X	Pediatric Physical Therapist		IL

General Provider Information

NPI Number	:	1467578054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA K ADANIN P.T.

Provider Business Mailing Address
First Line	:	2516 WAUKEGAN RD
Second Line	:	STE 353
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:	847-730-3111
Fax Number	:	847-730-3111

Provider Business Practice Location Address
First Line	:	2516 WAUKEGAN RD
Second Line	:	STE 353
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:	847-730-3111
Fax Number	:	847-730-3111

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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