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NPI Code Detail

MEDICARE: MICHELE MONACO PTA

MEDICARE:   MICHELE  MONACO  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
1225200000XPhysical Therapy Assistant225200000XIL

General Provider Information

NPI Number : 1598906133
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE MONACO PTA
Provider Business Mailing Address
First Line : 6042 S. MAYFIELD
Second Line :
City : CHICAGO
State : IL
Zip : 60638
Country : US
Telephone Number : 773-582-8984
Fax Number :
Provider Business Practice Location Address
First Line : 6042 S MAYFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-4404
Country : US
Telephone Number : 773-582-8984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2009
Last Update Date : 03/11/2009

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Directions to “ MICHELE MONACO PTA” Practice Location

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