MEDICARE: LINCOLN-WAY PHYSICAL THERAPY, LLC

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	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1609064211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN-WAY PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	7777 W LINCOLN HWY
Second Line	:	SUITE D
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9490
Country	:	US
Telephone Number	:	815-806-8777
Fax Number	:	815-806-9777

Provider Business Practice Location Address
First Line	:	7777 W LINCOLN HWY
Second Line	:	SUITE D
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9490
Country	:	US
Telephone Number	:	815-806-8777
Fax Number	:	815-806-9777

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL A RYBA
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	815-806-8777

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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