MEDICARE: LAURA FURMAN INC.

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	225X00000X	Occupational Therapist		IL

General Provider Information

NPI Number	:	1659567543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA FURMAN INC.

Provider Business Mailing Address
First Line	:	6624 N CLARK ST
Second Line	:	#3
City	:	CHICAGO
State	:	IL
Zip	:	60626-4698
Country	:	US
Telephone Number	:	773-895-3477
Fax Number	:	773-338-3005

Provider Business Practice Location Address
First Line	:	6624 N CLARK ST
Second Line	:	#3
City	:	CHICAGO
State	:	IL
Zip	:	60626-4698
Country	:	US
Telephone Number	:	773-895-3477
Fax Number	:	773-338-3005

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MS. LAURA ANN FURMAN
Credential	:
Telephone Number	:	773-895-3477

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/25/2007

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