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NPI Code Detail

MEDICARE: SHEREE ANN LAURELES PT

MEDICARE: SHEREE ANN LAURELES 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
1225100000XPhysical Therapist070017670IL

General Provider Information

NPI Number : 1548509516
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEREE ANN LAURELES PT
Provider Business Mailing Address
First Line : 4056 W 115TH ST APT 200
Second Line :
City : CHICAGO
State : IL
Zip : 60655-4334
Country : US
Telephone Number : 773-991-6661
Fax Number :
Provider Business Practice Location Address
First Line : 8001 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60620-5930
Country : US
Telephone Number : 773-436-6600
Fax Number : 773-434-6246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2013
Last Update Date : 02/11/2013

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