MEDICARE: DONNA JOY CECH 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	2251P0200X	Pediatric Physical Therapist		IL

General Provider Information

NPI Number	:	1487711032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA JOY CECH PT

Provider Business Mailing Address
First Line	:	219 ASHLAND AVE
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-2107
Country	:	US
Telephone Number	:	708-488-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 ASHLAND AVE
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-2107
Country	:	US
Telephone Number	:	708-488-0329
Fax Number	:

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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