MEDICARE: MS. MELISSA S WALKER PT CLT

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	QA00696700	NJ
2	225100000X	Physical Therapist	070022987	IL

General Provider Information

NPI Number	:	1528027661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA S WALKER PT CLT

Provider Business Mailing Address
First Line	:	625 ENTERPRISE DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8813
Country	:	US
Telephone Number	:	630-590-4029
Fax Number	:	630-590-4329

Provider Business Practice Location Address
First Line	:	555 E TOWNLINE RD STE 24
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1552
Country	:	US
Telephone Number	:	847-573-0051
Fax Number	:	847-573-0345

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	07/21/2022

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