MEDICARE: GINA M VEIT

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		IL

General Provider Information

NPI Number	:	1619027489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA M VEIT

Provider Business Mailing Address
First Line	:	2150 N LINCOLN PARK W
Second Line	:	#1008
City	:	CHICAGO
State	:	IL
Zip	:	60614-4652
Country	:	US
Telephone Number	:	773-857-3752
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 S PAULINA ST
Second Line	:	SUITE 732
City	:	CHICAGO
State	:	IL
Zip	:	60612-3808
Country	:	US
Telephone Number	:	312-942-5847
Fax Number	:

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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Directions to “ GINA M VEIT ” Practice Location

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