MEDICARE: PAIGE BURA

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	225200000X	Physical Therapy Assistant	160008199	IL

General Provider Information

NPI Number	:	1780549634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE BURA

Provider Business Mailing Address
First Line	:	33900 HARPER AVE STE 104
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48035-4258
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10801 S WESTERN AVE STE 103
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3223
Country	:	US
Telephone Number	:	773-596-3700
Fax Number	:	773-596-3701

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

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/23/2025

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Directions to “ PAIGE BURA ” Practice Location

Language	Start Address	Practice Location

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