MEDICARE: DR. AMANDA ANNE NERI PT, DPT

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	2251X0800X	Orthopedic Physical Therapist	070.026355	IL

General Provider Information

NPI Number	:	1750048567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA ANNE NERI PT, DPT

Provider Business Mailing Address
First Line	:	1730 N CLARK ST STE 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-5853
Country	:	US
Telephone Number	:	773-339-5451
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 W DIVISION ST UNIT C-1E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-4086
Country	:	US
Telephone Number	:	773-278-9050
Fax Number	:

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

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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