MEDICARE: CHICAGOLAND THERAPY ASSOCIATES LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1497772909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGOLAND THERAPY ASSOCIATES LTD

Provider Business Mailing Address
First Line	:	111 HOGARTH LN
Second Line	:	PO BOX 417
City	:	GLENCOE
State	:	IL
Zip	:	60022-1325
Country	:	US
Telephone Number	:	847-835-0660
Fax Number	:	847-835-0670

Provider Business Practice Location Address
First Line	:	111 HOGARTH LN
Second Line	:	BOX 417
City	:	GLENCOE
State	:	IL
Zip	:	60022-1325
Country	:	US
Telephone Number	:	847-835-0660
Fax Number	:	847-835-0670

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. SUSAN R GAINES
Credential	:	GTR L
Telephone Number	:	847-835-0660

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	06/12/2008

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Directions to “CHICAGOLAND THERAPY ASSOCIATES LTD ” Practice Location

Language	Start Address	Practice Location

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