MEDICARE: NOAH BOUCEKKINE PTA

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1548154107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH BOUCEKKINE PTA

Provider Business Mailing Address
First Line	:	1300 N ARLINGTON HEIGHTS RD STE 100
Second Line	:
City	:	ITASCA
State	:	IL
Zip	:	60143-3108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 N ARLINGTON HEIGHTS RD STE 100
Second Line	:
City	:	ITASCA
State	:	IL
Zip	:	60143-3108
Country	:	US
Telephone Number	:	630-967-2000
Fax Number	:

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

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	06/06/2025

Similar Medicare Providers

1710391883 — KIRSTIN GODINEZ PT, DPT
Practice Location Address:

1300 N ARLINGTON HEIGHTS RD
ITASCA, IL
60143-3108

Practice Phone: 630-967-2000
Practice Fax: 630-946-2519

1639644727 — LISA MCALPINE PT, DPT
Practice Location Address:

1300 N ARLINGTON HEIGHTS RD
ITASCA, IL
60143-3108

Practice Phone: 630-967-2000
Practice Fax: 630-946-2519

1912019548 — ITASCA FOOT AND ANKLE LTD
Practice Location Address:

209 N WALNUT ST
ITASCA, IL
60143-1730

Practice Phone: 630-773-2478
Practice Fax: 630-773-3695

1235233628 — MARIE CATHERINE SCHLUND D.P.M.
Practice Location Address:

209 N WALNUT ST
ITASCA, IL
60143-1730

Practice Phone: 630-773-2478
Practice Fax: 630-773-3695

1356873962 — DANIEL LEE REED DPM
Practice Location Address:

209 N WALNUT ST
ITASCA, IL
60143-1769

Practice Phone: 630-773-2478
Practice Fax:

1285029694 — DR. ALEXANDER MCKANNA DPM
Practice Location Address:

209 N WALNUT ST
ITASCA, IL
60143

Practice Phone: 630-773-2478
Practice Fax: 630-773-3695

Directions to “ NOAH BOUCEKKINE PTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.