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NPI Code Detail

MEDICARE: TYSON D SANCHEZ PT

MEDICARE:   TYSON D SANCHEZ  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 Therapist070010492IL

General Provider Information

NPI Number : 1639391709
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYSON D SANCHEZ PT
Provider Business Mailing Address
First Line : 205 W WACKER DR
Second Line : SUITE 1020
City : CHICAGO
State : IL
Zip : 60606-1216
Country : US
Telephone Number : 312-640-0329
Fax Number :
Provider Business Practice Location Address
First Line : 2731 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1336
Country : US
Telephone Number : 773-394-0796
Fax Number : 773-394-3342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 12/03/2008

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Directions to “ TYSON D SANCHEZ PT” Practice Location

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