MEDICARE: MEGAN M. SCHROEDER 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	070022550	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070022550	OTHER	IL	IL DEPT OF PROFESSIONAL REGULATION

General Provider Information

NPI Number	:	1760996219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN M. SCHROEDER PT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:	630-296-2222
Fax Number	:	630-759-9510

Provider Business Practice Location Address
First Line	:	5226 N NORTHWEST HWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4620
Country	:	US
Telephone Number	:	708-669-2493
Fax Number	:	773-272-9145

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

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/02/2018

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