MEDICARE: WINDY CITY PHYSICAL THERAPY, P.C.

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	261QP2000X	Physical Therapy Clinic/Center		IL

General Provider Information

NPI Number	:	1548448574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDY CITY PHYSICAL THERAPY, P.C.

Provider Business Mailing Address
First Line	:	1137 W TAYLOR ST
Second Line	:	UNIT 179
City	:	CHICAGO
State	:	IL
Zip	:	60607-4380
Country	:	US
Telephone Number	:	773-294-1582
Fax Number	:

Provider Business Practice Location Address
First Line	:	2515 N CLARK ST
Second Line	:	SUITE 907
City	:	CHICAGO
State	:	IL
Zip	:	60614-2730
Country	:	US
Telephone Number	:	773-294-1582
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, PHYSICAL THERAPIST
Name	:	MRS. DEANNINE BERNADETTE WEBER
Credential	:	P.T.
Telephone Number	:	773-294-1582

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	01/31/2008

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