MEDICARE: DAWID HEBDA

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	070.022644	IL

General Provider Information

NPI Number	:	1467994483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWID HEBDA

Provider Business Mailing Address
First Line	:	5016 N OAK PARK AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60656-3740
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5016 N OAK PARK AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60656-3740
Country	:	US
Telephone Number	:	773-719-5115
Fax Number	:

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

Provider Enumeration Date	:	11/08/2016
Last Update Date	:	01/13/2017

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Directions to “ DAWID HEBDA ” Practice Location

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