MEDICARE: CARY JOSE M ACOPIADO 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	225100000X	Physical Therapist	070011863	IL

General Provider Information

NPI Number	:	1770520611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARY JOSE M ACOPIADO DPT

Provider Business Mailing Address
First Line	:	5946 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5424
Country	:	US
Telephone Number	:	773-775-6637
Fax Number	:	773-775-6638

Provider Business Practice Location Address
First Line	:	5946 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5424
Country	:	US
Telephone Number	:	773-775-6637
Fax Number	:	773-775-6638

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	02/16/2024

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