MEDICARE: ARTEMIO SOTO 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
1	225100000X	Physical Therapist	070011053	IL

General Provider Information

NPI Number	:	1750501953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTEMIO SOTO PT

Provider Business Mailing Address
First Line	:	600 OAKMONT LN STE 600C
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-5548
Country	:	US
Telephone Number	:	630-575-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	4412 S PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-4011
Country	:	US
Telephone Number	:	773-847-3123
Fax Number	:	773-847-3778

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

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	03/16/2018

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Directions to “ ARTEMIO SOTO PT” Practice Location

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