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NPI Code Detail

MEDICARE: KATHARINE COSTANTINI MPT

MEDICARE: KATHARINE COSTANTINI MPT
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 Therapist070014491IL

General Provider Information

NPI Number : 1861533671
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE COSTANTINI MPT
Provider Business Mailing Address
First Line : 6000 W TOUHY AVE
Second Line : STE 202
City : CHICAGO
State : IL
Zip : 60646-1275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6000 W TOUHY AVE
Second Line : STE 202
City : CHICAGO
State : IL
Zip : 60646-1275
Country : US
Telephone Number : 773-774-4291
Fax Number : 773-774-4527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 10/13/2009

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Directions to “ KATHARINE COSTANTINI MPT” Practice Location

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