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NPI Code Detail

MEDICARE: LAURA A HACKL P.T.

MEDICARE: LAURA A HACKL P.T.
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
1225100000XPhysical Therapist070006505IL

General Provider Information

NPI Number : 1821390253
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA A HACKL P.T.
Provider Business Mailing Address
First Line : 1601 WALNUT AVE
Second Line :
City : WILMETTE
State : IL
Zip : 60091-1544
Country : US
Telephone Number : 847-256-4230
Fax Number :
Provider Business Practice Location Address
First Line : 984 WILLOW RD
Second Line : SUITE F
City : NORTHBROOK
State : IL
Zip : 60062-6821
Country : US
Telephone Number : 847-562-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2010
Last Update Date : 11/17/2010

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Directions to “ LAURA A HACKL P.T.” Practice Location

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