MEDICARE: KAREN ANN BURNETT MESTEK PT

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	070021236	IL

General Provider Information

NPI Number	:	1487043188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ANN BURNETT MESTEK PT

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 830
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8702
Country	:	US
Telephone Number	:	312-926-8810
Fax Number	:	312-926-8815

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 830
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8702
Country	:	US
Telephone Number	:	312-926-8810
Fax Number	:	312-926-8815

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

Provider Enumeration Date	:	01/19/2015
Last Update Date	:	10/20/2025

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