MEDICARE: KATHLEEN GEARY

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

General Provider Information

NPI Number	:	1598873713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN GEARY

Provider Business Mailing Address
First Line	:	6441 N CALDWELL AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-2739
Country	:	US
Telephone Number	:	312-775-3592
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 W PETERSON AVE STE 102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-6052
Country	:	US
Telephone Number	:	773-545-6885
Fax Number	:

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

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	07/08/2007

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